Abstract
Introduction: We sought to examine whether a positive family history of coronary heart disease and/or stroke (FamHx) is associated with presence of subclinical coronary atherosclerosis, as evaluated using CAC and CCTA, in asymptomatic individuals. We also evaluated whether these associations differ by FamHx type. Hypothesis: Coronary atherosclerotic plaque burden by CCTA and baseline CAC score will differ depending on the FamHx domain assessed. Methods: We included 2,359 asymptomatic participants free from known ASCVD from the Miami Heart Study, an ongoing, community-based, prospective cohort study where all participants underwent CAC, CCTA, and FHx assessment at baseline. Self-reported FamHx in first-degree relatives was evaluated using 5 definitions: any, premature, parental, sibling, and both parents and siblings. We used multivariable logistic regression models to estimate adjusted the associations between each FamHx definition, CAC>0, and presence of any coronary plaque on CCTA. Results: A total of 546 (23%) participants reported any FamHx (mean age 53.5 +/- 6.8 years, 54% female, 45% with CAC >0, and 50% with any coronary plaque). In analyses adjusted for sociodemographics, any FamHx was associated with CAC>0, and FamHx of both parents and siblings showed the strongest association with CAC>0 (OR 2.17; 95% CI 1.01, 4.67), followed by premature FamHx ( Table ). The associations for any and parental FamHx remained statistically significant after further adjusting for traditional risk factors, while the other definitions trended in the same direction, but the confidence intervals included the null value. Associations with any plaque on CCTA were weaker than for CAC>0, and none was statistically significant. Conclusion: FamHx, particularly a FamHx in both parents and siblings and premature FamHx, is associated with presence of CAC>0. The number of participants with several definitions of FHx was low, likely limiting statistical power.
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