Family history of coronary heart disease and the incidence and progression of coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA)

Atherosclerosis. 2014 Feb;232(2):369-76. doi: 10.1016/j.atherosclerosis.2013.11.042. Epub 2013 Dec 6.

Abstract

Objective: We evaluated family history as a predictor of incident and progressive coronary artery calcium (CAC) using data from the Multi-Ethnic Study of Atherosclerosis (MESA).

Background: MESA is a multi-center prospective study of 6814 asymptomatic individuals. The relationship between family history of coronary heart disease (CHD) and CAC incidence or progression has not been described previously.

Methods: A total of 5099 participants had detailed information about family history of CHD (late versus premature and parental versus sibling history). The mean time between CAC scans was 3.1 ± 1.3 years. The association of late versus premature family history was assessed against CAC change using multivariate regression model adjusted for demographics and cardiac risk factors.

Results: A family history of premature CHD was associated with an odds ratio (OR) of 1.55 (p < 0.01) for incident development of CAC after adjusting for risk factors and demographics. A premature family history was associated with 14.4 units (p < 0.01) greater volume scores compared to those with no family history in similarly adjusted models by median regression analysis. A combined parental and sibling family history was associated with the greatest incidence and progression in demographic-adjusted models. Caucasians demonstrated the most consistent predictive relationship between family history of premature CHD and incidence (p < 0.01) and progression (p < 0.05) of CAC, though no significant interaction with ethnicity was noted.

Conclusions: Family history of premature CHD is associated with enhanced development and progression of subclinical disease, independent of other risk factors, in a multiethnic, population-based study.

Keywords: Coronary calcium; Family history; Subclinical atherosclerosis.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Atherosclerosis / complications
  • Atherosclerosis / epidemiology
  • Calcinosis / complications*
  • Calcinosis / epidemiology*
  • Coronary Disease / complications*
  • Coronary Disease / epidemiology*
  • Disease Progression
  • Ethnicity
  • Family Health
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Prospective Studies
  • Regression Analysis
  • Risk Factors