Family history of coronary heart disease is more strongly associated with coronary than with carotid atherosclerosis in healthy asymptomatic adults.

OBJECTIVE: To investigate the potentially different relationship between family history (FH) of coronary heart disease (CHD) and carotid or coronary atherosclerosis.

METHODS: Asymptomatic healthy Korean adults older than 30 years who received both coronary CTA and carotid USG as part of a self-referred health check-up were retrospectively investigated (N=662). Multivariable logistic regression analysis was employed to investigate the relationship between FH of CHD and either coronary CTA or carotid USG results.

RESULTS: Adjusted for major CVD risk factors, FH of CHD was significantly associated with presence of any plaque in coronary arteries (aOR 2.10, 95% CI 1.07-4.16) and significant coronary stenosis (aOR 4.92, 95% CI 1.58-15.4), but was not associated with presence of any plaque in carotid arteries (aOR 1.27, 95% CI 0.61-2.63) and increased carotid IMT (aOR 1.44, 95% CI 0.40-5.22). Addition of FH of CHD had significant incremental predictive value to models for any coronary plaque (AUC 0.781 vs. 0.786, p=0.0351), and significant coronary stenosis (AUC 0.772 vs. 0.808, p=0.0129), but not for any carotid plaque (AUC 0.748 vs. 0.748, p=0.528), and increased carotid IMT (AUC 0.778 vs. 0.783, p=0.591).

CONCLUSION: To our knowledge, our study is the first to show specific comparative evidence that FH of CHD is more strongly associated with coronary than with carotid atherosclerosis. Our results suggest FH of CHD adds predictive value specifically to coronary atherosclerosis, but not carotid atherosclerosis, and suggest the possibility that screening for coronary atherosclerosis (via CAC) among low to intermediate risk asymptomatic adults with FH of CHD may be beneficial, who otherwise would not be screened according to traditional risk algorithms.