Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;15(6):1388-1396.
doi: 10.5114/aoms.2019.84677. Epub 2019 Nov 3.

Increased carotid plaque burden in patients with family medical history of premature cardiovascular events in the absence of classical risk factors

Paul W Atkins  1 , Hernán A Perez  2 , J David Spence  3 , Sonia E Muñoz  4 , Luis J Armando  2 , Néstor H García  4
Affiliations

Increased carotid plaque burden in patients with family medical history of premature cardiovascular events in the absence of classical risk factors

Paul W Atkins et al. Arch Med Sci. 2019 Oct.

Abstract

Introduction: The hypothesis that relates atherosclerosis to traditional risk factors (TRF) seems to be not as adequate as previously thought; other risk factors (RF) need to be considered to prevent atherosclerosis progression. Although a family medical history of premature cardiovascular events (FHx) has been considered the putative RF for decades, it has not been incorporated routinely into cardiovascular risk evaluation along with another RF. The objective of this study was to investigate whether FHx is associated with a higher atherosclerotic burden, measured as carotid total plaque area (TPA) in a population having no traditional RF.

Material and methods: The study included 4,351 primary care patients in Argentina. After excluding a personal history of cardiovascular disease (CVD) and TRF: hypertension, diabetes mellitus, hypercholesterolemia, smoking history, and body mass index (BMI) > 25 kg/cm2, 34 patients with FHx were identified. Compared to 56 matched controls TPA was 86% higher in FHx patients (p < 0.05). A second analysis performed in hypertensive patients but no other TRF; 32 patients with FHx were identified.

Results: Compared with 44 matched controls, TPA was 77% higher in FHx patients (p < 0.05). A final analysis using a generalized linear model with TPA progression as the response variable suggests that TPA progresses more rapidly in FHx patients compared to controls.

Conclusions: The FHx was associated with increased TPA burden and progression in the absence of other TRF. This supports ultrasound screening in FHx patients in order to detect high-risk patients who may benefit from early intervention.

Keywords: atherosclerosis; cardiovascular disease; family history; plaque; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of carotid total plaque area (mm2) in FHx-positive patients versus controls in the absence of all listed risk factors, Argentina (2007–2014). Error bars represent SEM
Figure 2
Figure 2
Comparison of carotid total plaque area (mm2) in FHx-positive patients versus controls in the presence of hypertension and absence of all other listed risk factors, Argentina (2007–2014). Error bars represent SEM
See this image and copyright information in PMC

References

    1. Chou R, Dana T, Blazina I, et al. Statin use for the prevention of cardiovascular disease in adults: a systematic review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016. 14-05206-EF-2. - PubMed
    1. Misra A. Risk factors for atherosclerosis in young individuals. J Cardiovasc Risk. 2000;7:215–29. - PubMed
    1. Ghehi C, Gabillard D, Moh R, et al. High correlation between Framingham equations with BMI and with lipids to estimate cardiovascular risks score at baseline in HIV-infected adults in the Temprano trial, ANRS 12136 in Cote d’Ivoire. PLoS One. 2017;12:e0177440. - PMC - PubMed
    1. Perez HA, Garcia NH, Spence JD, et al. Adding carotid total plaque area to the Framingham risk score improves cardiovascular risk classification. Arch Med Sci. 2016;12:513–20. - PMC - PubMed
    1. Zhu Y, Lin L, Wang C, et al. Impact of statins therapy on morphological changes in lipid-rich plaques stratified by 10-Year Framingham Risk Score: a serial optical coherence tomography study. Oncotarget. 2017;8:27401–1. - PMC - PubMed