Long-Term Consequences of Early Trauma on Coronary Heart Disease: Role of Familial Factors

Early childhood trauma has been associated with increased risk for subsequent coronary heart disease (CHD), but little is known regarding what role genetic and shared familial factors play in this relationship. Early trauma was measured retrospectively in 562 male middle-aged twins with the Early Trauma Inventory. CHD was assessed by history and by myocardial perfusion imaging with positron emission tomography [(13)N] ammonia. Coronary flow reserve, a measure of coronary microcirculatory function, was defined as the ratio of myocardial blood flow at rest to flow during stress. Early trauma was associated with a higher prevalence of CHD by clinical history, OR = 1.48 per early trauma inventory quartile increase, 95% CI [1.18, 1.86]. When within- and between-pair effects were estimated, only the between-pair association was significant, OR = 1.76, 95% CI [1.30, 2.40], showing that the odds of CHD in the twin pair increased as the average early trauma exposure in the pair increased. A marginal between-pair (but not within-pair) relationship was also found between early trauma and coronary flow reserve (n = 416, unstandardized B = -0.04, SE B = 0.02, p = .036). In conclusion, early trauma was associated with CHD and familial factors played a key role.