The Prognostic Value of Family History for the Estimation of Cardiovascular Mortality Risk in Men: Results from a Long-Term Cohort Study in Lithuania.

Abdonas Tamosiunas,Vilius Grabauskas,Jurate Klumbiene,Dalia Luksiene,Olga Vikhireva,Gailute Bernotiene,Vilija Malinauskiene,Dalia Virviciute,Janina Petkeviciene,Ricardas Radisauskas

doi:10.1371/journal.pone.0143839

Abdonas Tamosiunas, Vilius Grabauskas + Show 8 more

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https://doi.org/10.1371/journal.pone.0143839

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Abstract

AimTo evaluate the additional prognostic value of family history for the estimation of cardiovascular (CVD) mortality risk in middle-aged urban Lithuanian men.MethodsThe association between family history of CVD and the risk of CVD mortality was examined in a population-based cohort of 6,098 men enrolled during 1972–1974 and 1976–1980 in Kaunas, Lithuania. After up to 40 years of follow-up, 2,272 deaths from CVD and 1,482 deaths from coronary heart disease (CHD) were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) for CVD and CHD mortality.ResultsAfter adjustment for traditional CVD risk factors, the HR for CVD mortality was 1.24 (95% CI 1.09–1.42) and for CHD mortality 1.20 (1.02–1.42) in men with first-degree relatives having a history of myocardial infarction (MI), compared to men without positive family history. A significant effect on the risk of CVD and CHD mortality was also observed for the family history of sudden cardiac death and any CVD. Addition of family history of MI, sudden death, and any CVD to traditional CVD risk factors demonstrated modest improvement in the performance of Cox models for CVD and CHD mortality.ConclusionsFamily history of CVD is associated with a risk of CVD and CHD mortality significantly and independently of other risk factors in a middle-aged male population. Addition of family history to traditional CVD risk factors improves the prediction of CVD mortality and could be used for identification of high-risk individuals.

Highlights

Several prospective and case-control studies have shown that family history of coronary heart disease (CHD), stroke, and diabetes is a risk factor of cardiovascular disease (CVD) independent of well-established risk factors, such as age, sex, smoking, arterial hypertension (AH), obesity, and dyslipidemia [1,2,3]
After adjustment for traditional CVD risk factors, the hazard ratios (HR) for CVD mortality was 1.24 and for CHD mortality 1.20 (1.02–1.42) in men with first-degree relatives having a history of myocardial infarction (MI), compared to men without positive family history
A significant effect on the risk of CVD and CHD mortality was observed for the family history of sudden cardiac death and any CVD

Summary

Introduction

Several prospective and case-control studies have shown that family history of CHD, stroke, and diabetes is a risk factor of cardiovascular disease (CVD) independent of well-established risk factors, such as age, sex, smoking, arterial hypertension (AH), obesity, and dyslipidemia [1,2,3]. Recent prospective studies have demonstrated that cardiovascular risk prediction could be improved by adding family history of CVD to conventional risk factors in the prognostic models [6, 7]. Epidemiological studies demonstrated that the prevalence of conventional CVD risk factors is very high in Lithuanian population [10]. Prognostic values of these risk factors for the development of CVD in Lithuania have been found to be comparable to other populations [11, 12].

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