Arterial abnormalities in the offspring of patients with premature myocardial infarction

N Engl J Med. 2000 Sep 21;343(12):840-6. doi: 10.1056/NEJM200009213431203.

Abstract

Background: Findings from epidemiologic and autopsy studies suggest that the offspring of patients with premature coronary disease may be at increased risk for atherosclerosis. We undertook a study to determine whether changes in brachial-artery reactivity and thickness of the carotid intima and media, two markers of early atherosclerosis, are present in adolescents and young adults with a parental history of premature myocardial infarction.

Methods: We enrolled 40 healthy young people whose parents had had premature myocardial infarction (48 percent male; mean [+/-SD] age, 19.0+/-5.2 years) and 40 control subjects who were matched with the first group according to age and sex. All the subjects underwent high-resolution B-mode ultrasound examinations for the measurement of the brachial-artery vasodilatory response after arterial occlusion (i.e., reactive hyperemia) and the intima-media thickness of the distal common carotid arteries. Lipid profiles, blood pressure while at rest, body-mass index, and smoking status were also determined.

Results: As compared with the control subjects, the offspring of patients with premature myocardial infarction had lower flow-mediated reactivity of the brachial arteries (5.7+/-5.0 percent, vs. 10.2+/-6.6 percent in the control subjects; P=0.001) and greater mean intima-media thickness of the common carotid artery (0.49+/-0.08 mm, vs. 0.44+/-0.07 mm in the control subjects, P=0.004). In the subjects with a parental history of premature myocardial infarction, an inverse association was found between brachial-artery reactivity and carotid intima-media thickness (r=-0.46, P=0.003). In a conditional logistic-regression analysis, both brachial-artery reactivity and carotid intima-media thickness were significantly and independently correlated with a parental history of premature myocardial infarction.

Conclusions: Structural and functional changes are present at an early age in the arteries of persons with a parental history of premature myocardial infarction.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Apolipoproteins B / blood
  • Blood Flow Velocity
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiology*
  • Carotid Artery, Common / anatomy & histology*
  • Carotid Artery, Common / diagnostic imaging
  • Case-Control Studies
  • Child
  • Female
  • Humans
  • Lipoprotein(a) / blood
  • Logistic Models
  • Male
  • Myocardial Infarction* / genetics
  • Odds Ratio
  • Parents
  • Risk Factors
  • Tunica Intima / anatomy & histology
  • Tunica Media / anatomy & histology
  • Ultrasonography

Substances

  • Apolipoproteins B
  • Lipoprotein(a)