Younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature atherosclerosis

Abstract

Background: Premature coronary artery disease is one of the most pressing global issues in modern cardiology. The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients aged < 50 years with myocardial infarction (MI) compared to that in patients aged ≥50 years with MI and to that in young people without MI (no-MI < 50).

Methods: The studied group (MI < 50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI ≥ 50) with MI aged 50-92 years and 240 healthy people aged 30-49 years without a history of MI (no-MI < 50).

Results: There were statistically significant differences between the MI < 50 and MI ≥ 50 and no-MI < 50 groups regarding the family history of premature MI/ischaemic stroke and the percentage of patients with ≥2 relatives affected (10.8, 2.9, and 3.7%, respectively; p < 0.0001). There was a statistically significant difference in the patient age at the first MI occurrence among patients without a family history of premature CVD, those with 1 affected relative, and those with ≥2 affected first-degree relatives (56.6, 48.6 and 41.8 years, respectively) as well as those with affected first- and second-degree relatives (56.5, 50.7 and 47.0 years, respectively).

Conclusions: A younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature MI/ischaemic stroke. Thus, the family history of premature atherosclerosis involving not only first- but also second-degree relatives seems to be a valuable factor in CVD risk evaluation in young people.

Keywords: CVD family history; Myocardial infarction at a young age; Premature coronary artery disease.

Fig. 1

Differences among the MI < 50, MI ≥ 50 and no-MI < 50 groups in the percentage of cases with 0, 1 or ≥ 2 first- and second-degree relatives with a history of CVD events: a family history of premature CVD events with ≥2 affected relatives: 10.8% cases in the MI < 50 group vs 2.9% cases in the MI ≥50 group (p < 0.0001) and 10.8% cases in the MI < 50 group vs 3.7% cases in the no-MI < 50 group (p < 0.0001); b family history of CVD events with ≥2 affected relatives at every age: 21.4% cases in the MI < 50 group vs 12.7% cases in the MI ≥50 group (p < 0.0001) and 21.4% cases in the MI < 50 group vs 10.8% cases in the no-MI < 50 group (p < 0.0001)

Fig. 2

Relationship between the age of the patient’s first MI and the number of relatives with a history of CVD events. a Mean age with 95% Confidence Interval (CI) of patients with first episode MI: without a family history of premature CVD in first-degree relatives, with 1 affected relative and with ≥2 affected relatives: 56.6 [55.1–58.1], 48.6 [45.7–51.6] and 41.8 [32.8–50.8] years, respectively. b Mean age with 95% CI of patients with first episode MI: without a family history of premature CVD in first- and second-degree relatives, with 1 affected relative and with ≥2 affected first-degree relatives: 56.5 [55.0–58.0], 50.7 [47.6–53,7] and 47.0 [42.0–52.0] years, respectively. c Mean age with 95% CI of patients with first episode MI: without a family history of CVD at any age in first-degree relatives, with 1 affected relative and with ≥2 affected relatives: 57.9 [56.1–59.8], 51.9 [49.8–54.0] and 47.9 [43.4–52.4] years, respectively. d Mean age with 95% CI of patients with first episode MI: without a family history of CVD at any age in first- and second-degree relatives, with 1 affected relative and with ≥2 affected relatives: 58.1 [56.1–60.1], 52.5 [50.4–54.6] and 50.9 [47.7–54.2] years, respectively