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High-risk coronary atherosclerosis at CCTA in patients with Family histoRy of coronary Artery disease: An
Edoardo Conte1, Giuseppe Ciliberti2, Pedro Lopes3
1Galeazzi-Sant'Ambrogio Hospital IRCCS, Division of University Cardiology and Cardiac Imaging, Milan, Italy.
Insights
Patients with a family history of coronary artery disease (CAD) have a higher prevalence of high-risk atherosclerosis. This finding was observed even in individuals with a very low pre-test probability for obstructive CAD.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Limited data exists on coronary atherosclerosis prevalence in patients with a family history of coronary artery disease (CAD).
- Family history of CAD is a known risk factor, but its association with subclinical atherosclerosis requires further investigation.
Purpose of the Study:
- To investigate the prevalence and distribution of coronary atherosclerosis using coronary computed tomography angiography (CCTA) in patients with and without a family history of CAD.
- To compare the burden of atherosclerosis between these two groups.
Main Methods:
- Retrospective analysis of a multicenter observational study.
- Matching patients with a family history of CAD (FH of CAD) with controls without FH of CAD in a 2:1 ratio.
- Core laboratory evaluation of CCTA for atherosclerosis quantification.
Main Results:
- A total of 480 patients were analyzed (160 with FH of CAD, 320 without).
- The prevalence of high-risk atherosclerosis was significantly higher in patients with FH of CAD (62% vs. 43%, p=0.0001).
- Among patients with very low pre-test probability for obstructive CAD, 42% with FH of CAD showed high-risk atherosclerosis or obstructive CAD, compared to 19% without FH of CAD (p=0.0009).
Conclusions:
- Patients with a family history of CAD exhibit a greater prevalence of high-risk atherosclerosis.
- A significant proportion of individuals with a family history of CAD and very-low pre-test probability have high-risk atherosclerosis detected by CCTA.
Introduction:
No previous data specifically addressed the prevalence and distribution of coronary atherosclerosis in patients with family history (FH) of CAD. Aim of the present multicenter study was to explore the prevalence of atherosclerosis at coronary computed tomography angiography (CCTA) among patients with or without FH of CAD.
Material And Methods:
We performed a retrospective analysis of multicenter observational study including a consecutive cohort of patients who prospectively underwent clinically indicated CCTA for suspected CAD. A group of patients with FH of CAD were matched in a 2:1 fashion with a control group without FH of CAD from the same consecutive cohort. All CCTA were evaluated in a core lab for advanced atherosclerosis evaluation and quantification. Differences in prevalence of atherosclerosis at CCTA were reported and compared between patients with or without FH of CAD.
Results:
A total of 480 patients were enrolled, 160 with FH of CAD and 320 without (mean age 61.7±9.6, female prevalence 41.9%). Clinical characteristics did not differ between the two groups, but the prevalence of high-risk atherosclerosis was significantly higher among those with FH of CAD (62% vs. 43%, respectively, p=0.0001). Among patients clinically classified as very low probability of obstructive CAD, high-risk atherosclerosis or obstructive CAD was found at CCTA in 42% of those with FH of CAD vs. 19% of those without (p=0.0009).
Conclusion:
This prospective multicenter study shows that patients with a family history of CAD have a higher prevalence of high-risk atherosclerosis. Moreover, nearly half of those with very-low pre-test probability of obstructive CAD and a family history of CAD had high-risk atherosclerosis at CCTA.
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