Family history of myocardial infarction predicts incident coronary heart disease in postmenopausal women with diabetes: the Women's Health Initiative Observational Study.
Family history of myocardial infarction predicts incident coronary heart disease in postmenopausal women with diabetes: the Women's Health Initiative Observational Study.
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DOI：
10.1002/dmrr.1010
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发表时间：
2009-11
影响因子：
8
通讯作者：
Johnson, Karen C.
中科院分区：
文献类型：
--
作者：
Li, Rongling;O'Sullivan, Mary J.;Robinson, Jennifer;Safford, Monika M.;Curb, David;Johnson, Karen C.
糖尿病是冠心病（CHD）的危险因素，但CHD并不发生在所有糖尿病个体中。本研究的目的是评估心肌梗死（MI）家族史与绝经后糖尿病女性冠心病事件之间的关系。我们在妇女健康倡议观察性研究中对2642名基线时无冠心病的绝经后糖尿病妇女进行了一项前瞻性队列研究。家族史被定义为一级亲属中MI的先证者报告。CHD事件定义为非致死性MI、冠状动脉血运重建或CHD死亡。在7.3（±1.8）年的随访期间，14.3%的参与者发生了CHD。冠心病发生的风险高出50%（HR = 1.50，95% CI：1.20-1.87，p = 0.0003），在至少一个一级亲属中有MI家族史的患者中，（HR = 1.79，95%CI：1.36-2.35，P < 0.0001）如果有两个或两个以上的一级亲属患有心肌梗死，与没有家族史的参与者相比，调整协变量后。冠心病的危险性随着收缩压（SBP）的升高而增加（HR = 1.01，95% CI：1.003-1.02，p = 0.001），但随着舒张压升高而降低（HR = 0.98，95% CI：0.97-0.999，p = 0.005）和每周两次或多次体力活动（HR = 0.70，95% CI：0.52-0.93，p = 0.02）。结果表明，MI家族史可预测糖尿病绝经后妇女的冠心病。应密切关注这些妇女的血压控制和体力活动。
Diabetes is a risk factor for coronary heart disease (CHD) but CHD does not occur in all diabetic individuals. The goal of this study was to assess the relationship between family history of myocardial infarction (MI) and incident CHD in diabetic postmenopausal women. We conducted a prospective cohort study among 2642 diabetic postmenopausal women without CHD at baseline in the Women’s Health Initiative Observational Study. Family history was defined as a proband report of MI in first-degree relatives. Incident CHD was defined as non-fatal MI, coronary revascularization, or CHD death. During 7.3 (±1.8) years of follow-up, 14.3% of the participants had incident CHD. The risk of incident CHD was 50% higher (HR = 1.50, 95% CI: 1.20–1.87, p = 0.0003) in those with a family history of an MI in at least one first-degree relative, and 79% higher (HR = 1.79, 95% CI: 1.36–2.35, P < 0.0001) if two or more first-degree relatives had an MI, compared to participants without a family history, after adjustment for covariates. The CHD risk increased with elevated systolic blood pressure (SBP) (HR = 1.01, 95% CI: 1.003–1.02, p = 0.001) but decreased with elevated diastolic BP (HR = 0.98, 95% CI: 0.97–0.999, p = 0.005) and with two or more episodes per week of physical activity (HR = 0.70, 95% CI: 0.52–0.93, p = 0.02). The results suggest that a family history of MI predicts CHD in diabetic postmenopausal women. Close attention should be paid to BP control and physical activity in these women.
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