Premature Cardiovascular Disease Is Common in Relatives of Patients With Premature Peripheral Atherosclerosis

Valentine, R. James; Verstraete, Richard; Clagett, G. Patrick; Cohen, Jonathan C.

doi:10.1001/archinte.160.9.1343

Cited by 38 publications

(25 citation statements)

References 29 publications

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“…Premature peripheral vascular disease can lead to silent coronary artery disease and death. [1][2][3][4][5] Polyarteritis nodosa (PAN) is a necrotizing vasculitis involving medium and small arteries of almost any organ sparing the lungs and the venous system. It is a rare disease that can be progressively fatal, with an incidence of 14 to 30.7 per million, predominantly affecting middle-aged men in a 1.5:1 ratio.…”

Section: Discussionmentioning

confidence: 99%

A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

Golovine

Parikh

2008

J GEN INTERN MED

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Polyarteritis nodosa is a rare necrotizing vasculitis that can be progressive and fatal, and its initial presenting symptom may be leg claudication due to peripheral vascular ischemia. To date, there have been fewer than ten case reports of polyarteritis nodosa presenting as peripheral vascular disease. We report a case of a 38-year-old man initially diagnosed to have premature peripheral vascular disease who presented 1 year later with symptoms consistent with giant cell arteritis and subsequently developed bowel ischemia leading to a fatal outcome. Based on the autopsy and the patient's clinical course, the final diagnosis was polyarteritis nodosa. This case illustrates the challenges in diagnosing polyarteritis nodosa and the importance of considering vasculitis in young patients presenting with atypical presentations of diseases such as peripheral vascular disease or giant cell arteritis.

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Section: Discussionmentioning

confidence: 99%

A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

Golovine

Parikh

2008

J GEN INTERN MED

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“…This estimate can be obtained through various types of familial aggregation studies. [42][43][44][45][46][47] Three family studies to date have reported estimates of the heritability of PAD. [45][46][47] In all 3 of the studies, the ABI was used as a surrogate for the presence and severity of PAD.…”

Section: The Role Of Genetics In Padmentioning

confidence: 99%

“…Consistent with this possibility is the fact that established strong predictors of clinically significant PAD explain a relatively small proportion of the total variance of ABI in the 2 family studies that reported these estimates. 45,47 Evidence quite suggestive for a genetic basis of PAD comes from a study of Valentine et al 43 where they showed that both premature, symptomatic CAD and occult lowerextremity vascular disease are more common in families of probands with premature PAD, indicating a strong familial aggregation of vascular disease. However, this study was not able to quantify the degree of familial aggregation that was independent of that related to smoking and other established risk factors of atherosclerosis.…”

Section: The Role Of Genetics In Padmentioning

confidence: 99%

Genetic Susceptibility to Peripheral Arterial Disease: A Dark Corner in Vascular Biology

Knowles

Assimes

et al. 2007

ATVB

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Abstract-Peripheral arterial disease (PAD) is characterized by reduced blood flow to the limbs, usually as a consequence of atherosclerosis, and affects Ϸ12 million Americans. It is a common cause of cardiovascular morbidity and an independent predictor of cardiovascular mortality. Similar to other atherosclerotic diseases, such as coronary artery disease, PAD is the result of the complex interplay between injurious environmental stimuli and genetic predisposing factors of the host. Genetic susceptibility to PAD is likely contributed by sequence variants in multiple genes, each with modest effects. Although many of these variants probably alter susceptibility both to PAD and to coronary artery disease, it is likely that there exists a set of variants specifically to alter susceptibility to PAD. Despite the prevalence of PAD and its high societal burden, relatively little is known about such genetic variants. This review summarizes our limited present knowledge and gives an overview of recent, more powerful approaches to elucidating the genetic basis of PAD. We discuss the advantages and limitations of genetic studies and highlight the need for collaborative networks of PAD investigators for shedding light on this dark corner of vascular biology. (Arterioscler Thromb Vasc

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“…CHD was considered to be early if men were aged Յ55 years and women were aged Յ65 years at the time of diagnosis. 13,14 The criteria for severe CHD were stenoses Ͼ50% in coronary angiography in at least 2 main coronary arteries. Until September 1997, 6395 persons had undergone angiography in the Kuopio University Hospital, and a total of 1834 subjects were identified as having severe premature CHD.…”

mentioning

confidence: 99%

Cardiovascular Risk Factors Associated With Insulin Resistance Cluster in Families With Early-Onset Coronary Heart Disease

Kareinen

Viitanen

Halonen

et al. 2001

ATVB

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Abstract-Coronary heart disease (CHD) is a multifactorial disease caused by environmental and genetic factors. CHD clusters in families, but it is not known whether susceptibility to early-onset CHD is associated with the clustering of cardiovascular risk factors. Therefore, we determined the levels of cardiovascular risk factors among siblings with and without severe early-onset CHD drawn from 101 Finnish families. Probands with CHD, compared with their siblings without CHD, had, respectively, higher 2-hour insulin levels (475. Key Words: risk factors Ⅲ coronary disease Ⅲ insulin resistance C oronary heart disease (CHD) is a multifactorial disease having environmental and genetic components. Smoking, elevated blood pressure, and high cholesterol levels are classic risk factors for CHD, but they explain, at most, 50% of the risk for CHD. 1,2 Also, diabetes, hyperinsulinemia, low HDL cholesterol level, hypertriglyceridemia, obesity, central obesity, and physical inactivity increase the risk for CHD. 3 Several previous prospective 4,5 and cross-sectional 6,7 studies have demonstrated that CHD clusters in families, and genetic factors have been suggested to explain almost 50% of the risk for CHD in individuals aged Ͻ60 years. 8 Although several candidate genes and environmental factors have been proposed to explain accelerated atherosclerosis, the mechanisms behind the familial clustering of CHD have remained unexplained. 9 Two possibilities have to be considered. First, early-onset CHD could be due to environmental or genetic factors independent of adverse changes in known cardiovascular risk factors. Second, adverse changes in known cardiovascular risk factors, eg, dyslipidemia, 10 elevated blood pressure, 11 obesity, 12 and diabetes, 6 aggregating in families with early-onset CHD and caused by environmental or genetic factors could explain the excess of atherosclerosis.To investigate these 2 possibilities, we determined the levels of cardiovascular risk factors among affected and unaffected siblings from families with premature CHD to evaluate whether the clustering of early-onset CHD in families could be explained by the aggregation of adverse changes in known cardiovascular risk factors. Methods SubjectsAll subjects participating in the present study were Finnish and living in Eastern Finland. Since 1983, the Kuopio University Hospital has been responsible for Ͼ90% of coronary angiographies performed in Eastern Finland (North Savo, North Karelia, Mikkeli, and Savonlinna Central Hospital districts). Probands who had severe CHD at an early age were identified from the coronary angiogram register of the Kuopio University Hospital. The formation of the study population is described in Figure 1. CHD was considered to be early if men were aged Յ55 years and women were aged Յ65 years at the time of diagnosis. 13,14 The criteria for severe CHD were stenoses Ͼ50% in coronary angiography in at least 2 main coronary arteries. Until September 1997, 6395 persons had undergone angiography in the Kuopio University Hospital, ...

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Premature Cardiovascular Disease Is Common in Relatives of Patients With Premature Peripheral Atherosclerosis

Cited by 38 publications

References 29 publications

A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

Genetic Susceptibility to Peripheral Arterial Disease: A Dark Corner in Vascular Biology

Cardiovascular Risk Factors Associated With Insulin Resistance Cluster in Families With Early-Onset Coronary Heart Disease

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