Arterial stiffness is increased in families with premature coronary artery disease
- Ties A Mulders1,
- Bas van den Bogaard1,
- Annemieke Bakker1,
- Mieke D Trip1,
- Erik S Stroes1,
- Bert-Jan H van den Born1,
- Sara-Joan Pinto-Sietsma1,2
- 1Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands
- 2Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
- Correspondence to Dr Sara-Joan Pinto-Sietsma, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Postbus 22660, Amsterdam 1100 DD, The Netherlands;
- Accepted 18 November 2011
- Published Online First 22 December 2011
Objective A positive family history of premature coronary artery disease (CAD) is a risk factor for cardiovascular disease (CVD), independent of traditional risk factors. Therefore, currently used risk algorithms poorly predict risk in these individuals. Novel methods are thus needed to assess cardiovascular risk. Pulse-wave velocity (PWV) might be such a method, but it is unknown whether PWV is increased in first-degree relatives of patients with premature CAD.
Design Observational case–control study.
Setting Academic hospital.
Patients Patients with premature CAD and a positive family history of premature CVD (n=50), their first-degree relatives without CVD (n=50) and unrelated controls (n=50).
Main Outcome Measures PWV was measured with using an Arteriograph system. Differences in PWV were assessed by a generalised linear model and multinomial logistic regression.
Results Patients with premature CAD had a higher PWV compared with first-degree relatives and controls (9.69±2.90 m/s vs 8.15±1.96 m/s and 7.38±1.08 m/s; p<0.05 patients vs all groups). Linear regression showed all groups related to PWV, with patients having the highest PWV and controls the lowest (p<0.0001). Furthermore, PWV was associated with first-degree relatives (OR 1.32, 95% CI 1.02 to 1.72; p<0.05) and premature CAD (OR 1.72, 95% CI 1.32 to 2.24; p<0.05) compared with controls. These findings were independent of blood pressure and other traditional risk factors.
Conclusions Patients with premature CAD and their first-degree relatives had higher PWV compared with controls, independent of other risk factors. This holds promise for the future, in which arterial stiffness might play a role in risk prediction within families with premature CAD.
- Arterial stiffness
- congenital heart disease
- CT scanning
- family history
- premature coronary artery disease
- pulse-wave velocity
See Editorial, p 431
Competing interests None.
Patient consent Obtained.
Ethics approval This study was approved by the Institutional Review Board of the Academic Medical Centre, Amsterdam.
Provenance and peer review Not commissioned; externally peer reviewed.