Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Analysis from the HORIZONS-AMI Trial

Konstanze Ertelt, Philippe Genereux, Gary S. Mintz, Sorin J. Brener, Ajay J. Kirtane, Thomas C. McAndrew, Dominic P. Francese, Ori Ben-Yehuda, Roxana Mehran, Gregg W. Stone

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Family history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials/Methods: Baseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%). Results: These patients were younger (median 56.7 vs. 62.1. years, P<. 0.0001) and more often current smokers (52.4% vs. 43.5%, P<. 0.0001), had more dyslipidemia (47.7% vs. 41.1%, P=. 0.0003), less diabetes mellitus (14.1% vs. 17.5%, P=. 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P=. 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P=. 0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P=. 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P=. 0.046 and 4.8% vs. 7.7%, P=. 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95%CI]. =. 1.00 [0.70, 1.44], P=. 0.98). Conclusions: A family history of premature CAD is not an independent predictor of higher mortality.

Original languageEnglish (US)
Pages (from-to)375-380
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume15
Issue number8
DOIs
StatePublished - Nov 1 2014

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Percutaneous Coronary Intervention
Coronary Artery Disease
Mortality
Dyslipidemias
ST Elevation Myocardial Infarction
Diabetes Mellitus

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Ertelt, Konstanze ; Genereux, Philippe ; Mintz, Gary S. ; Brener, Sorin J. ; Kirtane, Ajay J. ; McAndrew, Thomas C. ; Francese, Dominic P. ; Ben-Yehuda, Ori ; Mehran, Roxana ; Stone, Gregg W. / Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction : Analysis from the HORIZONS-AMI Trial. In: Cardiovascular Revascularization Medicine. 2014 ; Vol. 15, No. 8. pp. 375-380.
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title = "Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: Analysis from the HORIZONS-AMI Trial",
abstract = "Family history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials/Methods: Baseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4{\%}). Results: These patients were younger (median 56.7 vs. 62.1. years, P<. 0.0001) and more often current smokers (52.4{\%} vs. 43.5{\%}, P<. 0.0001), had more dyslipidemia (47.7{\%} vs. 41.1{\%}, P=. 0.0003), less diabetes mellitus (14.1{\%} vs. 17.5{\%}, P=. 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P=. 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8{\%} vs. 90.6{\%}, P=. 0.002), and myocardial blush grade 2 or 3 (83.2{\%} vs. 78.0{\%} P=. 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8{\%} vs. 3.0{\%}, P=. 0.046 and 4.8{\%} vs. 7.7{\%}, P=. 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95{\%}CI]. =. 1.00 [0.70, 1.44], P=. 0.98). Conclusions: A family history of premature CAD is not an independent predictor of higher mortality.",
author = "Konstanze Ertelt and Philippe Genereux and Mintz, {Gary S.} and Brener, {Sorin J.} and Kirtane, {Ajay J.} and McAndrew, {Thomas C.} and Francese, {Dominic P.} and Ori Ben-Yehuda and Roxana Mehran and Stone, {Gregg W.}",
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Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction : Analysis from the HORIZONS-AMI Trial. / Ertelt, Konstanze; Genereux, Philippe; Mintz, Gary S.; Brener, Sorin J.; Kirtane, Ajay J.; McAndrew, Thomas C.; Francese, Dominic P.; Ben-Yehuda, Ori; Mehran, Roxana; Stone, Gregg W.

In: Cardiovascular Revascularization Medicine, Vol. 15, No. 8, 01.11.2014, p. 375-380.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

T2 - Analysis from the HORIZONS-AMI Trial

AU - Ertelt, Konstanze

AU - Genereux, Philippe

AU - Mintz, Gary S.

AU - Brener, Sorin J.

AU - Kirtane, Ajay J.

AU - McAndrew, Thomas C.

AU - Francese, Dominic P.

AU - Ben-Yehuda, Ori

AU - Mehran, Roxana

AU - Stone, Gregg W.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Family history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials/Methods: Baseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%). Results: These patients were younger (median 56.7 vs. 62.1. years, P<. 0.0001) and more often current smokers (52.4% vs. 43.5%, P<. 0.0001), had more dyslipidemia (47.7% vs. 41.1%, P=. 0.0003), less diabetes mellitus (14.1% vs. 17.5%, P=. 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P=. 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P=. 0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P=. 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P=. 0.046 and 4.8% vs. 7.7%, P=. 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95%CI]. =. 1.00 [0.70, 1.44], P=. 0.98). Conclusions: A family history of premature CAD is not an independent predictor of higher mortality.

AB - Family history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials/Methods: Baseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%). Results: These patients were younger (median 56.7 vs. 62.1. years, P<. 0.0001) and more often current smokers (52.4% vs. 43.5%, P<. 0.0001), had more dyslipidemia (47.7% vs. 41.1%, P=. 0.0003), less diabetes mellitus (14.1% vs. 17.5%, P=. 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P=. 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P=. 0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P=. 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P=. 0.046 and 4.8% vs. 7.7%, P=. 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95%CI]. =. 1.00 [0.70, 1.44], P=. 0.98). Conclusions: A family history of premature CAD is not an independent predictor of higher mortality.

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DO - 10.1016/j.carrev.2014.09.002

M3 - Article

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JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

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