This study was designed to assess the prevalence of major cardiovascular risk factors in familial premature coronary artery disease (P-CAD), affecting two or more siblings within one sibship.
Background
Premature CAD has a genetic component. It remains to be established whether familial P-CAD is due to genes acting independently from major cardiovascular risk factors.
Methods
We recruited 213 P-CAD survivors from 103 sibships diagnosed before age ≤50 (men) or ≤55 (women) years old. Hypertension, hypercholesterolemia, obesity, and smoking were documented at the time of the event in 163 patients (145 men and 18 women). Each patient was compared with two individuals of the same age and gender, diagnosed with sporadic (nonfamilial) P-CAD, and three individuals randomly sampled from the general population.
Results
Compared with the general population, patients with sporadic P-CAD had a higher prevalence of hypertension (29% vs. 14%, p < 0.001), hypercholesterolemia (54% vs. 33%, p < 0.001), obesity (20% vs. 13%, p < 0.01), and smoking (76% vs. 39%, p < 0.001). These risk factors were equally or even more prevalent in patients with familial P-CAD (43% [p < 0.05 vs. sporadic P-CAD], 58% [p = 0.07], 21% and 72%, respectively). Overall, only 7 (4%) of 163 of patients with familial P-CAD and 22 (7%) of 326 of patients with sporadic P-CAD had none of these conditions, as compared with 167 (34%) of 489 patients in the general population.
Conclusions
Classic, remediable risk factors are highly prevalent in patients with familial P-CAD. Accordingly, a major contribution of genes acting in the absence of these risk factors is unlikely.
This study was supported by the Swiss National Foundation for Scientific Research (grant nos. 44471.95 and 32-61623.00 to Dr. Mooser and grant nos. 3.856-0.83, 3.938.0.85, 32-9271.87 and 32-30110.90 to MONICA at Vaud/Fribourg), Bern, Switzerland; the Octave Botnar and Placide Nicod Foundation, Lausanne, Switzerland; MONICA at Canton de Vaud, Lausanne, Switzerland; and Glaxo Smith Kline, Greenford, U.K. Dr. Mooser is presently affiliated with GlaxoSmithKline in Greenford, UK.