Abstract
The objective of this study was to determine the predictive factor of a combination of traditional and new risk factors for coronary heart diseases (CHDs) as well as the echocardiographic findings in children of parents suffering premature myocardial infarction in comparison with controls. Overall, 239 adolescents aged 12 to 18 years including 112 children of parents with premature CHD (<55 years) and 127 age- and sex-matched controls without such a family history. In addition to measuring anthropometric indexes and blood pressure, serum fasting blood sugar, lipid profile, C-reactive protein, Lpa, and oxidized LDL as well as carotid-intima media thickness and left ventricular mass were determined. Factor analysis showed that clusters of inflammatory factors and markers of oxidation as well as carotid-intima media thickness and left ventricular mass were correlated with each other and were associated with a positive parental history of premature CHD in youths. These findings complement the functional and structural changes in arteries of adults with a familial predisposition to CHD and underscore the importance of using a high-risk approach for primordial/primary prevention of CHD from early life and of considering the screening of children and siblings in the management of patients with premature CHD.
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American Academy of Pediatrics (1992) National Cholesterol Education Program: report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 89:525–584
Anath OR, Lydia E, Cuno S et al (2003) Cardiovascular risk factors and increased carotid intima-media thickness in healthy young adults: the atherosclerosis risk in young adults (ARYA) study. Arch Intern Med 163:1787–1792
Celermajer DS, Sorensen KE, Bull C et al (1994) Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 24:1468–1474
Clarkson P, Celermajer DS, Powe AJ et al (1997) Endothelium-dependent dilatation is impaired in young healthy subjects with a family history of premature coronary disease. Circulation 96:3378–3383
Cohen MS (2004) Fetal and childhood onset of adult cardiovascular diseases. Pediatr Clin N Am 51:1697–1719
Davis PH, Dawson JD, Riley WA, Lauer RM (2001) Clinical investigation and reports that carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age. Circulation 104:2815
Dekkers JC, Treiber FA, Kapuku G, Snieder H (2003) Differential influence of family history of hypertension and premature myocardial infarction on systolic blood pressure and left ventricular mass trajectories in youth. Pediatrics 111(6; Pt 1):1387–1393
Devereux RB, Alonso DR, Lutas EM et al (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458
Ferrieres J, Elias A, Ruidavets J et al (1999) Carotid intima-media thickness and coronary heart disease risk factors in a low-risk population. J Hypertens 17:743–748
Friedwald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502
Jousilahti P, Puska P, Vartiainen E et al (1996) Parental history of premature coronary heart disease: an independent risk factor of myocardial infarction. J Clin Epidemiol 49:497–503
Juonala M, Viikari JS, Laitinen T et al (2004) Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the Cardiovascular Risk in Young Finns study. Circulation 110:2774–2777
Haji SA, Ulusoy RE, Patel DA et al (2006) Predictors of left ventricular dilatation in young adults (from the Bogalusa Heart Study). Am J Cardiol 98:1234–1237
Kelishadi R, Sarraf Zadegan N, Nadery GA et al (2002) Atherosclerosis risk factors in children and adolescents with or without family history of premature coronary artery disease. Med Sci Monit 8:425–429
Kelishadi R, Nadery GA, Asgaiy S (2002) Oxidized LDL metabolites in children with high family risk for premature CVD. Ind J Pediatr 69:755–759
Kelishadi R, Sabet B, Khosravi A (2003) Anticardiolipin antibody of adolescents and age of myocardiial infraction in parents. Med Sci Monit 9:515–518
Kelishadi R, Ardalan G, Gheiratmand R, Ramezani A (2006) Is family history of premature cardiovascular diseases appropriate for detection of dyslipidemic children in population-based preventive medicine programs? CASPIAN study. Pediatr Cardiol 27:729–736
Kuller L, Borhanl N, Furberg C et al (1994) Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 139:1164–1179
Levy D, Garrison RJ, Savage DD et al (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566
Lonn E (1999) Carotid artery intima-media thickness: A new noninvasive gold standard for assessing the anatomic extent of atherosclerosisand cardiovascular risk? Clin Invest Med 22:158–160
Makedou A, Kourti M, Makedou K et al (2005) Lipid profile of children with a family history of coronary heart disease or hyperlipidemia: 9-year experience of an outpatient clinic for the prevention of cardiovascular diseases. Angiology 56:391–395
Meigs JB (2000) Invited Commentary: insulin resistance syndrome? Syndrome X? Multiple metabolic syndrome? A syndrome at all? Factor analysis reveals patterns in the fabric of correlated metabolic risk factors. Am J Epidemiol 152:908–911
Myers RH, Kiely DK, Cupples LA, Kannel WB (1990) Parental history is an independent risk factor for coronary artery disease: the Framingham Study. Am Heart J 120:963–969
Pignoli P, Tremoli E, Poli A et al (1986) Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 74:1399–1406
Sabri MR, Kelishadi R (2007) The thickness of the intimal and medial layers of the carotid arteries, and the index of left ventricular mass, in children of patients with premature coronary arterial disease. Cardiol Young 17:1–8
Sass C, Herbeth B, Chapet O et al (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens 16:1593–1602
Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases. Part II. Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 104:2855–2864
Zureik M, Touboul PJ, Bonithon-Kopp C et al (1999) Differential association of common carotid intima-media thickness and carotid atheroscleroticplaques with parental history of premature death fromcoronary heart disease. The EVA Study. Arterioscler Thromb Vasc Biol 19:366–371
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Kelishadi, R., Sabri, M., Motamedi, N. et al. Factor Analysis of Markers of Inflammation and Oxidation and Echocardiographic Findings in Children with a Positive Family History of Premature Coronary Heart Disease. Pediatr Cardiol 30, 477–481 (2009). https://doi.org/10.1007/s00246-009-9412-7
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DOI: https://doi.org/10.1007/s00246-009-9412-7