Cardiac CT findings in patients with family history of premature CAD: an observational study

Migraine with aura (MA) is associated with the persistence of patent foramen ovale (PFO) in about 50% of cases, and migraineurs tend to have larger shunts than controls, suggesting that right-to-left shunt (RILES) determined by PFO could play a role in triggering migraine attacks. Moreover, some preliminary reports have suggested that PFO closure may give relief to both migraine and aura attacks. The aim of this study was to clarify if shunt-associated migraine (SAM) has clinical features that allow a distinction from shunt-unrelated migraine (SUM), in a prospective, multicentre, observational study (SAM study). We enrolled consecutive MA patients, who underwent a structured, standardized questionnaire for family and personal history and for detailed migraine features. All were systematically screened for RILES with transcranial Doppler, and for coagulation disorders. Overall, 460 patients were included; the SUM and SAM classes comprised 58% and 42% of patients, respectively. SAM patients were significantly younger (34.1 ± 10 vs. 37.1 ± 11 years), had a more frequent family history of migraine (76% vs. 66%) and a higher frequency of sensory symptoms of aura (51% vs. 41%); by contrast, there was a lesser association of SAM with other cardiac abnormalities and with coagulation disorders. The SAM study suggests that the effect of RILES on migraine features is not relevant. The higher family history of migraine in SAM suggests a possible genetic linkage between migraine and RILES.

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Clinical trends of scalp alopecia areata: a tertiary care hospital based observational study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200607 ◽

2020 ◽

Vol 6 (2) ◽

pp. 193

Author(s):

Pallavi Singh ◽

Milind A. Patvekar ◽

Bhavika Shah ◽

Alisha Mittal ◽

Asmita Kapoor

Keyword(s):

Family History ◽

Observational Study ◽

Alopecia Areata ◽

Tertiary Care Hospital ◽

Past History ◽

Tertiary Care ◽

Disease Onset ◽

Epidemiological Data ◽

Care Hospital ◽

History Of

Background: Alopecia areata is one of the commonest types of non-scarring alopecia involving the scalp and/or body. As there is paucity of recent epidemiological data from our country, this study was conducted to determine the latest clinical and epidemiological trends of scalp alopecia areata.Methods: A hospital-based observational study consisting of 100 cases of clinically diagnosed scalp alopecia areata who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of six months. Socio-demographic and clinical information was collected and clinical examination was performed on all patients. The data was evaluated using appropriate statistical methods.Results: Out of the 100 cases enrolled, males (64%) outnumbered females (36%). The commonest presenting age group was 21-30 years (44%). Disease onset was sudden in 80% patients and 59% cases had a progressive disease course. Majority (75%) had a disease duration of less than 3 months. Majority cases were asymptomatic (80%) with no precipitating factors (90%). Past history and family history of alopecia areata were present in 13% and 9% cases, respectively. Personal and family history of associated diseases were present in 27% and 22% patients, respectively. Most patients had single (61%), patchy (83%) lesions with occiput (45%) being the commonest initial site. Nail changes were present in 22% cases, of which pitting (13%) was the commonest nail finding.Conclusions: This study reflects the clinical profile of scalp alopecia areata in a tertiary care hospital.

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Association between lipoprotein(a) levels, apo(a) isoforms and family history of premature CAD in young Asian Indians

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2008.01.016 ◽

2008 ◽

Vol 41 (7-8) ◽

pp. 453-458 ◽

Cited By ~ 21

Author(s):

Jasvinder K. Gambhir ◽

Harsimrut Kaur ◽

Krishna M. Prabhu ◽

Joel D. Morrisett ◽

Daljeet S. Gambhir

Keyword(s):

Family History ◽

Asian Indians ◽

Lipoprotein A ◽

History Of ◽

Premature Cad

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Profile of Hypospadias Cases in Central Java, Indonesia

Journal of Biomedicine and Translational Research ◽

10.14710/jbtr.v1i1.27 ◽

2015 ◽

Vol 1 (1) ◽

pp. 16

Author(s):

Ziske Maritska ◽

Ardy Santosa ◽

Mahayu Dewi Ariani ◽

Achmad Zulfa Juniarto ◽

Sultana MH Faradz

Keyword(s):

Risk Factors ◽

Family History ◽

Environmental Factors ◽

Observational Study ◽

Maternal Age ◽

Genetic Factors ◽

Multifactorial Disease ◽

Central Java ◽

Birth Characteristics ◽

History Of

Background: Hypospadia is believed to be a multifactorial disease. The risk factors that may induce the formation of hypospadias are environmental factors, endocrine disruptors, and genetic factors. The aim of this study was to describe the profile of hypospadias patients who visited the Center for Biomedical Research (CEBIOR), Faculty of Medicine, Diponegoro University, Semarang, Indonesia.Methods: This study is an observational study, using patients’ medical record in CEBIOR from 2010 to 2012. The hypospadias cases were classified into syndromic, isolated and severe hypospadias based on their phenotype. The history of pregnancy, birth characteristics, and family history of the patients were described.Results: There were 120 cases of hypospadias, consisted of 48.33% severe hypospadias, 41.67% mild isolated hypospadias and 10% syndromic hypospadias. There were 38.33% hypospadias cases whose mothers were being exposed to repellant usage and 39.17% cases whose fathers were smoking. Forty (33.33%) probands’ mothers were aged above 35 years old when they gave birth to their affected son.Conclusion: Majority of hypospadias cases were severe and mild isolated. Environtmental factors including maternal age more than 35 years old, use of repellant, and smoking fathers were found in this study.

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Abstract 14925: Inverse Association between Family History of Premature Coronary Artery Disease and the Risk of Death in Patients with Coronary Artery Disease

Circulation ◽

10.1161/circ.130.suppl_2.14925 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ahmed Abdi Ali ◽

Abdel Aziz Shaheen ◽

Danielle A Southern ◽

Mei Zhang ◽

Merril Knudston ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Family History ◽

Clinical Characteristics ◽

System Level ◽

Premature Coronary Artery Disease ◽

Inverse Association ◽

History Of ◽

Premature Cad ◽

Artery Disease

Background: Family history (FHx) of premature coronary artery disease (CAD) is an established cardiovascular risk factor. However the impact of FHx on outcomes of patients with CAD is unclear. Methods & Results: The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) Program is an inclusive prospective registry of patients undergoing coronary angiography. Between April 2002 and Mar 2013, 99,667 patients were enrolled. 30,030 (30%) patients reported FHx, defined as a first degree relative with premature CAD (males <55, females <65 years). We investigated the association between FHx and all-cause mortality at 1 year, using multivariable logistic regression, adjusting for clinical characteristics, comorbidities, and the extent of CAD. Patients with normal angiography (15.2%) were excluded. Compared to those without FHx, those with FHx were younger (60.1 vs 64.0 years, p<0.0001), more likely female (30.5% vs 29.5%; p=0.0018), and were less likely to have previously diagnosed CAD, congestive heart failure, stroke, or chronic kidney disease (all p<0.0001) Conversely, those with FHx were more likely current smokers (31.8% vs 25.3%) and to have hypertension (68.8% vs 65.5%) and dyslipidemia (75.7% vs 68.1%), all p<0.0001). The indication for angiography was an acute coronary syndrome (ACS) in 55% of both groups (p=0.57), and the extent of CAD was similar. Overall, FHx was associated with reduced 1-year mortality in fully adjusted models (odds ratio [OR] 0.56, 95% CI 0.51 to 0.62). This protective association was present in patients with and without a previous CAD event (OR 0.66 [95% CI 0.60 to 0.78] vs 0.53 [95% CI 0.47 to 0.59], respectively), and in patients with and without an ACS (OR 0.56 [95% CI 0.50 to 0.63] vs 0.56 [95% CI 0.48 to 0.65], respectively). There was slight attenuation of association with age, but FHx remained protective even in those aged 80 or more (OR 0.72, 95% CI 0.57 to 0.90). Conclusion: In patients with angiographic CAD, a family history of premature CAD is associated with lower mortality, independent of clinical characteristics, mode of presentation, and extent of disease. Further investigation of potential patient- and system-level mediators of this seemingly paradoxical relationship is required.

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P3432Coronary artery calcium score is of limited sensitivity in detecting subclinical atherosclerosis in young individuals with family history of coronary artery disease

European Heart Journal ◽

10.1093/eurheartj/ehz745.0306 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Huang ◽

A Mugharbil ◽

M Anastasius ◽

S Ghadiri ◽

J Leipsic ◽

...

Keyword(s):

Coronary Artery ◽

Family History ◽

Subclinical Atherosclerosis ◽

Age Groups ◽

Calcium Score ◽

Atherosclerotic Plaques ◽

History Of ◽

Premature Cad ◽

Artery Disease ◽

Limited Sensitivity

Abstract Introduction Family history of premature coronary artery disease (CAD) is known to predispose individuals to adverse CAD events, often at a younger age. Current risk stratification strategy is suboptimal, as up to 50% of individuals were considered “low-risk” prior to their first presentation of myocardial infarction. Coronary artery calcium score (CACS) is a marker of atherosclerosis and provides incremental value in risk stratification. However, the utility of CACS may be limited in younger patients as they often have non-calcified atherosclerotic plaques. In this study, we evaluate the sensitivity of CACS in detecting subclinical atherosclerosis in different age groups. Method From 310 referrals to a specialized unit in the management of early atherosclerosis, 222 individuals with a family history of premature CAD (defined as CAD events in first-degree family members, male<55 and female<65) and aged between 35 and 55 were enrolled for assessment of their CAD risks. Individuals with possible, probably or definite familial hypercholesterolemia were excluded. In addition to clinical and risk factor evaluation, cardiac CT and CACS were performed in select individuals, at the discretion of the treating physician. Results Of the 141 (59% male, mean age 45.9±6.0 year) individuals that completed clinical evaluation, 65 (73% male, mean age 47.4±6.9 years) have subclinical atherosclerosis (defined by the presence of atherosclerotic plaques in any of the coronary artery segments in cardiac CT). Of them, 52 have CACS>0, giving an overall sensitivity of 80%. The breakdown by age group is shown in table 1. The sensitivity of CACS in detecting subclinical atherosclerosis is quite modest in younger individuals (60% in individuals <45 year-old) but improves with patient age (>85% in >45 years). Table 1. Sensitivity of CACS in different age groups Age group True Positive Fast Negative Sensitivity N (CAC+ CTCA+) (CAC+ CTCA−) (%) <40 6 4 60 10 41–45 7 4 55 11 46–50 19 3 86 22 51–55 20 1 95 21 Conclusion In younger individuals (<45 years) with family history of premature CAD, CACS is of limited sensitivity in detecting subclinical atherosclerosis, and should not be used to rule out CAD. Further studies are warranted.

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FAMILY HISTORY OF PREMATURE CAD AND TRADITIONAL CLINICAL RISK FACTORS IN PREDICTING OBSTRUCTIVE CORONARY ATHEROSCLEROSIS IN YOUNG PATIENTS REFERRED FOR CORONARY CT ANGIOGRAPHY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)60708-5 ◽

2010 ◽

Vol 55 (10) ◽

pp. A75.E707

Author(s):

Aiden Abidov ◽

Kavitha M. Chinnaiyan ◽

James H. Wegner ◽

Gilbert L. Raff

Keyword(s):

Risk Factors ◽

Family History ◽

Ct Angiography ◽

Coronary Atherosclerosis ◽

Coronary Ct Angiography ◽

Young Patients ◽

Clinical Risk Factors ◽

Coronary Ct ◽

History Of ◽

Premature Cad

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Abstract 11661: A Family History of Premature Coronary Artery Disease is Associated With Location and Severity of Angiographically Defined Coronary Artery Stenosis

Circulation ◽

10.1161/circ.130.suppl_2.11661 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Muhammad Hammadah ◽

Riyaz S Patel ◽

Danny J Eapen ◽

Ayman Samman Tahhan ◽

Nima Ghasemzadeh ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Family History ◽

Premature Coronary Artery Disease ◽

Left Main ◽

Vessel Stenosis ◽

History Of ◽

Female Relative ◽

Premature Cad ◽

Artery Disease

Introduction: A family history (FH) of premature coronary artery disease (CAD) is an important prognostic risk factor. Emerging evidence suggests that CAD location as well as severity may be heritable. We sought to investigate the association between a FH of premature CAD with the location and severity of angiographically phenotyped CAD. Methods: 2854 patients undergoing coronary angiography were enrolled from the Emory Cardiovascular Biobank. A FH of CAD was defined as having any male or female relative with history of CAD at age ≤55 or ≤65 year old respectively. Coronary angiograms were phenotyped using a 17 segment AHA model. Proximal disease was defined as having ≥70% lesion in the left main or proximal portion of any of the three major epicardial arteries, while CAD severity was assessed by counting the number of vessels with ≥70% stenosis. Results: Among this population (mean age 63±12, male 67%, diabetes 33%), 21% reported a positive FH of premature CAD. After adjustment for age, gender, and traditional cardiovascular risk factors, those with a positive FH were more likely to have significant CAD than those without a positive FH (OR 1.3 (1.1-1.7)). They were 40% more likely to have single vessel (OR 1.4(1.1-1.7)) and up to 80% more likely to have multi-vessel disease (OR 1.8 (1.4-2.4)). In addition, they were also much more likely to have left main (OR 1.9 (1.3-2.8)) and proximal vessel involvement (OR 1.5 (1.2 - 1.9)), but not distal vessel stenosis (OR 1.1 (0.9-1.4)). Conclusions: A FH of CAD is associated with a greater likelihood of multi-vessel and proximal anatomical disease. Whether site specific disease is genetically mediated remains to be explored.

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