Myocardial infarction: a parental history of ischaemic heart disease before 60 increased the risk.

Clinical bottom line (level 1b)

  1. People whose parents had angina or a myocardial infarction before the age of 60 were at increased risk of having a myocardial infarction.
Jousilahti et al: Journal of Clinical Epidemiology 1996; 49 (5): 497-503
Expires March 2003

The study

Prospective cohort study with ?objective ?blinded outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: two provinces, Finland

15620 patients (aged 30 to 59; mean ~43, 52% female) well

Excluded if
  • incomplete history on parental ischaemic heart disease or incomplete data on risk factors or indicators of socioeconomic status
  • previous history of myocardial infarction



Factors studied:
  • cardiovascular risk factors, socioeconomic status, body mass index
  • men aged < 55 years: premature coronary heart disease in parents myocardial infarction, or angina before the age of 60
  • men aged 55 to 60: premature coronary heart disease in parents
  • women aged < 55 years: premature coronary heart disease in parents
  • women aged 55 to 60: premature coronary heart disease in parents




A Cox proportional hazards model was used to adjust for confounding factors.

?100% followed for 12 years
Outcomes studied:
  • myocardial infarction or coronary death

The evidence

outcome time to outcome number of patients/total number %
(95% CI)
myocardial infarction or coronary death 12 years / %
(% to %)

prognostic factor for
myocardial infarction or coronary death 		time to outcome adjusted RR
(95% CI)
men aged < 55 years: premature coronary heart disease in parents 12 years 1.64
(1.30 to 2.06)
men aged 55 to 60: premature coronary heart disease in parents 12 years 1.46
(1.15 to 1.86)
women aged < 55 years: premature coronary heart disease in parents 12 years 2.66
(1.65 to 4.28)
women aged 55 to 60: premature coronary heart disease in parents 12 years 1.48
(1.05 to 2.10)

Comments

  1. No event rates were provided.

Citation

  1. Jousilahti P, Puska P, Vartiainen E, et al: Parental history of premature coronary heart disease: an independent risk factor of myocardial infarction. Journal of Clinical Epidemiology 1996; 49 (5): 497-503
Search Terms:
Contributor: Chris Ball and Clare Wotton, February 2000
Reviewer:

Clinical Question.
    Patient well
    Intervention or Exposure parental history of premature coronary artery disease
    Outcome myocardial infarction