Cameron John Hague MD, Presenter: Nothing to Disclose

Bruce B. Forster MD, Abstract Co-Author: Medical Advisory Board, General Electric Company

Catalin Taraboanta, Abstract Co-Author: Nothing to Disclose

Jiri Frohlich, Abstract Co-Author: Nothing to Disclose

Determine whether asymptomatic first degree relatives (FDRs) of patients with early onset coronary artery disease (CAD) have higher coronary artery calcium (CAC) scores than matched controls with no family history. The CAC scan results in FDRs were also correlated with carotid ultrasound intimal media thickness (CIMT) analysis, as well as with traditional cardiovascular risk factors.

57 (47+9 years old; 44% male, 56% female) first degree relatives of patients with early onset of CAD (<50 years of age for men and <60 for women) were referred for CAC scoring by 64-slice MDCT. The study cohort also had evaluations of carotid intima media thickness (CIMT), blood pressure, smoking history, and cholesterol. The control group is comprised of a pool of 616 self-referred subjects (57+10 years old; 76% male, 24% female) who reported no family history of cardiovascular disease, chest pain or diabetes on a pre-CT questionnaire. Positive disease status was established as CAC values over the 75th percentile. All statistical analysis was performed with SPSS 12.0 Graduate pack edition.

1) FDRs had a two-fold increase in risk of having disease at CAC scan than controls; Mantel-Haenszel common odd ratio estimate is 1.96 with 95%CI (1.04 – 3.67), p<0.05. After adjusting for age and gender, increases in total Agatston score (β=0.102, p<0.01) and total volume score (β=0.103, p<0.05) are predicted by positive family history of CAD. 2) In FDRs, CAC score correlated with age (r=0.425, p<0.005), diastolic blood pressure (r=0.267, p<0.05) and Framingham risk score (r=0.279, p<0.05). Total calcium volume correlates strongly with CIMT measurements: average intima-media thickness (r= 0.402, p<0.005), total plaque area (r=0.460, p<0.001), average total thickness (r=0.525, p<0.001), total area (r=0.498, p<0.001) and plaque number (r=0.478, p<0.001) in the FDR group.

CAC, measured by 64-slice MDCT, is greater in FDRs than matchedcontrols. CAC scores correlate highly with carotid ultrasound findings in FDRs.

: The acquired data will allow for the further risk stratification of individuals within a subject group at elevated risk for development of coronary artery disease

Hague, C, Forster, B, Taraboanta, C, Frohlich, J, Coronary Calcium Scores in Subjects with a Family History of Early Onset Coronary Artery Disease.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002145.html