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Published on: October 19, 2016
Arterial stiffness is increased in families with premature coronary artery disease
Ties A Mulders1, Bas van den Bogaard, Annemieke Bakker
1Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Insights
Individuals with a family history of premature coronary artery disease (CAD) have increased arterial stiffness. Pulse-wave velocity (PWV) is higher in these individuals and their relatives, suggesting PWV may aid in cardiovascular disease risk prediction.
Area of Science:
- Cardiology
- Vascular Biology
- Genetics
Background:
- A positive family history of premature coronary artery disease (CAD) is an independent risk factor for cardiovascular disease (CVD).
- Current risk algorithms inadequately predict CVD risk in individuals with a family history of premature CAD.
- Novel methods are needed to assess cardiovascular risk in these high-risk individuals.
Purpose of the Study:
- To investigate whether pulse-wave velocity (PWV), a measure of arterial stiffness, is increased in first-degree relatives of patients with premature CAD.
- To compare PWV in patients with premature CAD, their first-degree relatives, and unrelated controls.
Main Methods:
- An observational case-control study was conducted at an academic hospital.
- Participants included patients with premature CAD (n=50), their first-degree relatives without CVD (n=50), and unrelated controls (n=50).
- Pulse-wave velocity (PWV) was measured using an Arteriograph system, and data were analyzed using generalized linear models and multinomial logistic regression.
Main Results:
- Patients with premature CAD exhibited significantly higher PWV compared to both 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, respectively; p<0.05).
- PWV was significantly associated with being a first-degree relative (OR 1.32, 95% CI 1.02 to 1.72; p<0.05) and having premature CAD (OR 1.72, 95% CI 1.32 to 2.24; p<0.05) compared to controls.
- These associations remained significant and independent of traditional risk factors such as blood pressure.
Conclusions:
- Patients with premature CAD and their first-degree relatives demonstrate elevated PWV compared to controls, irrespective of other risk factors.
- Arterial stiffness, as measured by PWV, shows potential for risk prediction in families with a history of premature CAD.
- This finding highlights the utility of PWV in identifying individuals at increased cardiovascular risk within familial contexts.
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).
Interventions:
None.
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.
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