شیوع و ریسک فاکتورهای بیماری عروق کرونر در بستگان درجه اول افراد با بیماری زودرس عروق کرونر

Background: Premature coronary artery disease (CAD) has a familial predisposition and occurrence. We determined the prevalence of CAD and related risk factors in individuals with a history of premature CAD in their first-degree relatives. Methods: This study included 700 healthy individuals with a history of premature CAD in their parents or siblings in Tehran Heart Center in 2003-2004. History of smoking, diabetes mellitus (DM) or hypertension was taken. Fasting levels of blood sugar (FBS), triglycerides (TG), cholesterol, LDL and HDL were measured. Noninvasive studies for CAD were performed with resting echocardiography (ECG) and ECG with exercise tolerance test (ETT). Patients with positive findings for ischemia in these tests underwent a myocardial perfusion scan and if positive proceeded to coronary angiography. Results: The mean age of our subjects was 35.2 (15-65) years. DM was found in 5.3%, smoking in 14.7%, hypertension in 20.6%, cholesterol above 200 mg/dl in 39.9%, TG above 150 mg/dl in 58.6%, LDL above 130 mg/dl in 38% and HDL below 40 mg/dl in 32.6%. In addition, 6.4% had ECG changes and 3% echocardiographic abnormalities in favor of ischemia. ETT was positive in 7.3% and myocardial perfusion scan in 2.1%. Coronary angiography showed 50-70% stenosis in eight patients (1.1%) and >70% in four patients (0.6%).Conclusion: High cholesterol, TG and LDL and low HDL were found among our subjects. Risk factor determination in these individuals may prove to be beneficial. Noninvasive tests for CAD yield low true-positive results and are not recommended in the population as a whole. In certain subgroups, including those with persons older than 40 years and diabetic patients, these tests may be useful.