Positive family history of coronary artery disease is associated with reduced myocardial vasoreactivity in healthy men

Objective Positive family history as a risk factor for coronary artery disease seems to be most important in subjects who otherwise are at low risk. We examined the association between family history of coronary artery disease and myocardial vasoreactivity in healthy men. Methods 35 non-smoking healthy men (age 35 ± 7 years) were studied: 16 had positive family history of coronary artery disease and 19 had negative family history. The myocardial blood flow measurements were performed basally and during adenosine infusion (140 μg/kg/min) with and without simultaneous physiological hyperinsulinemia (insulin infusion at a rate of 1 mU/kg/min) using positron emission tomography and O-15-water. Results Basal myocardial blood flow was similar between the subjects with positive and negative family history of coronary artery disease (0.79 ± 0.19 and 0.79 ± 0.21 mL g− 1 min− 1, NS). Adenosine stimulated flow was significantly reduced in subjects with positive family history (3.0 ± 0.5 vs 4.0 ± 1.2 mL g− 1 min− 1, respectively, p = 0.003). During physiological hyperinsulinemia adenosine stimulated flow was further enhanced in both groups but significantly blunted in subjects with positive family history (3.7 ± 0.9 vs 5.2 ± 1.5 mL g− 1 min− 1, respectively, p = 0.001). These differences remained significant after simultaneous controlling for age, BMI, HbA1c, LDL-cholesterol, HDL-cholesterol and blood pressure (p = 0.002). Conclusions Healthy non-smoking men with positive family history of coronary artery disease are characterized by impaired myocardial vasoreactivity.