Clinical And Coronary Lesion Characteristics In Patients Underwent PCI With Family History Of Coronary Heart Disease

Objective:To explore the clinical and coronary lesion characteristics in patients underwent percutaneous coronary intervention(PCI) with family history(FH) of coronary heart disease(CHD).Methods:A total of 13800 inpatients whose underwent PCI from December 2006 to June 2014 were enrolled in the study, screening patients with FH of CHD(positive group). Classified by FH of CHD with only parents, only siblings, and both parents and siblings FH(mixed group). We selected 1000 patients underwent PCI without FH of CHD as negative group. To contrasted the clinical and coronary lesion characteristics in the groups.Results:1. Patients in positive group(1300, 9.4%) and negative group had no difference in body mass index(BMI), average lesion counts and the incidence of diabetes, hypertension, left main lesions and single/double/three vessel lesions. The average age and proportion of smokers of positive group are significantly lower than negative group(60.3:61.9,P=0.000;49.8%:55.3%,P=0.010). In positive group, the proportion of men and the incidence of hyperlipidemia, myocardial infarction, right coronary artery lesion, ostial lesion, chronic total occlusion(CTO) and the average number of stent placement were significantly greater than the negative group(70.4%:62.0%,67.4%:44.8%,36.0%:29.1%,P =0.000;61.6%:59.4%,P=0.007;21.0%:14.5%,P=0.000;12.0%:8.5%,P=0.006;1.93:1.74,P=0.000).2. The average age of the parent group were significantly lower than negative group( 57.3:61.9, P=0.000), the proportion of men and the incidence of hyperlipidemia, average lesion counts, ostial lesion, CTO were significantly greater( 75.3%: 62.0%, P=0.000; 70.0%:44.8%, P=0.000; 1.90:1.98, P=0.045;19.9%:14.5%,P=0.005;11.7%:8.5%,P=0.037). The proportion of smoker and single vessel lesion,BMI of the sibling group were lower than negative group(25.9:26.2,P=0.018;30.0%: 37.3%,P=0.005),The average age and the number of stent placement, the incidence of hyperlipidemia, myocardial infarction, three vessel lesions, ostial lesion, CTO were significantly greater(63.2: 61.9,P=0.006;1.98:1.74,P=0.000;63.3%:44.8%,P=0.000; 38.4%:29.1%,P=0.000;36.2%:29.6%,P=0.008;19.8%:14.5%,P=0.011;12.2%:8.5%,P=0.020). The incidence of single vessel lesions in mixed group were lower than negative group(29.0%:37.3%, P=0.031), the incidence of hypertension and hyperlipidemia, myocardial infarction, three vessel lesions, ostial lesion, CTO were significantly greater(66.0%:60.3%, P=0.011;82.4%:44.8%, P=0.000; 36.2%:29.1%, P=0.046; 37.1%:29.6%, P=0.047;28.0%:14.5%,P=0.000;12.7%:8.5%,P=0.011).3. Contrast to the parent group(n=599,46.1%), the age, average lesion counts and the incidence of three vessel lesions, diabetes in sibling group(n=515,39.6%) were greater(63.2:57.3, P=0.000; 2.06:1.90, P=0.001; 30.3%:23.8%, P=0.015;36.2%:28.4%,P=0.005),but the proportion of men, BMI, smoker and single vessel lesion were lower(66.1%:75.3%,P=0.001;45.2%:53.7%,P=0.003;30.0%:39.1%,P=0.002;25.9:26.4,P=0.002). The age, average lesion counts and the incidence of hypertension, hyperlipidemia and ostial lesion in mixed group(n=186,14.3%)were greater than those in parent group(P<0.05). BMI and the incidence of hyperlipidemia, hypertension in mixed group were greater than those in sibling group too(P<0.05).4. The middle score of Gensini of patients in the three groups had no difference. The proportion of low score in patient group were significantly greater than sibling and negative group(27.5% vs 20.8%,P=0.009;27.5% vs 18.0%,P =0.000), the higher score were lower than negative group(24.2% vs 33.3%,P=0.000), the highest score were lower than sibling group(21.7% vs 30.5%,P=0.001). The proportion of low score and middle score in sibling group and negative group had no difference, but the higher score were lower and the highest score were greater.Conclusions:1. 9.4% of the PCI patients had a positive family history. The patients in positive group were younger than negative group, the proportion of men and the incidence of hyperlipidemia, myocardial infarction, right coronary artery lesion, ostial lesion, CTO and the average number of stent placement were greater.2. The patients in parent group were younger than negative group, the proportion of men and the incidence of hyperlipidemia, average lesion counts, ostial lesion, CTO were greater. The proportion of smoker and single vessel lesion,BMI of the sibling group were lower than negative group,The average age and the number of stent placement, the incidence of hyperlipidemia, myocardial infarction, three vessel lesions, ostial lesion, CTO were greater. The incidence of single vessel lesions in mixed group were lower than negative group, the incidence of hypertension and hyperlipidemia, myocardial infarction, three vessel lesions, ostial lesion, CTO were greater.3. Contrast among the subgroup, the age, average lesion counts and the incidence of, diabetes, three vessel lesions, and the highest score of Gensini in sibling group were greater than parent group. The results indicate sibling history of coronary heart disease is a stronger risk factor for coronary heart disease than a parent history.4. Overall, patients with FH of CHD were younger than those no FH, especially when the parent were involved. Patients with FH of CHD exposure to the other cardiovascular risk factors was higher, coronary artery lesion more severe, especially when the sibling were involved.