Prevalence of Asymptomatic Coronary Heart Disease in the Siblings of Young Myocardial Infarction Patients as Detected by Coronary Computer Tomography Angiography: A Pilot Study

• Published in: Heart, lung & circulation lung & circulation, 2018-02, Vol.27 (2), p.205-211
• Main Authors: Shah, Nadim, FRACP, Wong, Chiew, PhD, Cox, Nicholas, FRACP, Kelly, Anne-Maree, MD, FACEM, Soon, Kean, PhD
• Format: Article
• Language: English
• Subjects: Adult; Asymptomatic Diseases; Cardiovascular; Cardiovascular risk score; Computed Tomography Angiography - methods; Coronary Angiography - methods; Coronary computer tomography angiography; Coronary Disease - complications; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Coronary Vessels - diagnostic imaging; Female; Humans; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Pilot Projects; Prevalence; Prospective Studies; Risk factor; Screening; Siblings; Survival Rate - trends; Victoria - epidemiology; Young adult
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2017.03.160

Background There is little data on the prevalence of coronary heart disease (CHD) in the young. The study aimed to estimate the prevalence of asymptomatic CHD in siblings of young patients with myocardial infarction (MI) using coronary computed tomography angiography (CCTA). Methods Prospective observational data was collected on siblings of patients aged ≤55 years presenting with acute MI and having coronary stenosis ≥50% on invasive coronary angiography in at least one epicardial coronary artery. Inclusion criteria included ages 30–55 and 30–60 years for males and females respectively. Outcome of interest was obstructive CHD by coronary computer tomography angiography (CCTA), which was defined by either moderate (50–69% stenosis) and/or severe (≥70% stenosis). Results Fifty participants were studied of whom 20 (40%) were male. Thirty (60%) were current or ex-smokers, 4 (8%) had diabetes, 8 (16%) had hypertension and 26 (52%) had dyslipidaemia. Obstructive CHD by CCTA was detected in 9 (18%, 95% CI 9%–31%) participants and 3 (6%, 95% CI 1%–17%) participants were found to have severe luminal stenosis. The median radiation dose was 3.9 (IQR 0.9) mSv. Conclusions Approximately a fifth of siblings of young MI patients were found to have asymptomatic but obstructive CHD detected on CCTA of which one third was severe. This is a group in whom screening for CHD warrants further investigation.