Endothelial Function in Adolescents with a History of Premature Coronary Artery Disease in One Parent

M Hashemi, Y Kiani, R Basiratnia, F Bayat


Background: In young adults, a family history of premature coronary artery disease (CAD), as well as genetic and environmental factors are independent risk factors for coronary artery disease.
Methods: Endothelial function was studied in 30 children (21 boys and 9 girls with mean age of 14.9 +/- 2.3 years old) of patients with documented CAD (men 45 and women 50 years old). Chidren did not have any history of diabetes mellitus, dyslipidemia, hypertension, and smoking (active/passive). Using vascular ultrasound, we measured resting Basal Brachial artery Diameter (BBD) and Endothelium-Dependent Dilatation (EDD) in response to increased flow and sublingual glyceryltrinitrate (GTN), an Endothelium-Independent Dilation (EID). These parameters were also measured in 30 control subjects with normal parents (18 boys and 12 girls with mean age of 14.2 +/- 2/5years old) and results were compared with each other.
Results: Adolescents in CAD group had abnormal Endothelial Dependent Dilatation or EDD/BBD (8.5 +/- 3.4% vs 11.8 +/- 4.5% in control subjects; P= 0.003).Endothelial Independent Dilatation (EID/BBD) in the positive fimily history group was significantly more than control subjects (18.5 +/- 6.7% vs 11.9 +/- 5.2%; P <0.001). EDD/EID or the index of endothelial function was significantly lower in the positive family history group (0.92 +/- 0.05 vs 1+/- 0.03; P<0.001). There was no difference in EDD/EID index between those with history of premature CAD in mother (7 cases) and those with history of premature CAD in father (23 cases) (0.92 +/- 0.04 vs 0.91+/- 0.05).
Conclusion: Normal adolescents without any cardiovascular risk factors but a history of premature coronary artery disease in one parent may have endothelial dysfunction, and there is no difference whether the CAD is in mother or father.
Keywords: Endothelial dependent dilation, family history, CAD risk factors, premature coronary artery disease

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