Differential Impact of Maternal Versus Paternal Coronary Artery Disease History on Cardiac Function and Angiographic Severity in Offspring: A Cross-Sectional Study.

Abstract

Background: Parental history is an established risk factor for coronary artery disease (CAD), but the relative effects of maternal and paternal history on disease severity and cardiac function remain unclear, particularly in South Asian populations. This study compared maternal and paternal CAD history in relation to angiographic severity and left ventricular systolic function.

Methodology: This hospital-based cross-sectional study included 250 consecutive adults undergoing diagnostic coronary angiography at Hayatabad Medical Complex, Peshawar, Pakistan, from October 2025 to March 2026. Participants were classified as having paternal history only (n=65), maternal history only (n=45), both parents affected (n=24), or no parental history (n=116). CAD severity was assessed using the Gensini score, and left ventricular ejection fraction (LVEF) was measured by transthoracic echocardiography. Multivariable logistic regression adjusted for conventional cardiovascular risk factors.

Results: Patients with maternal CAD history had the greatest disease severity. Median Gensini scores were 69 (IQR 50–92) in the maternal history group, 52 (35–73) in the paternal history group, and 46 (30–66) in those without parental history (p<0.001). Mean LVEF was lower with maternal history (48.3 ± 7.9%) than with paternal history (52.6 ± 8.1%) or no parental history (58.7 ± 7.6%) (p=0.03). Maternal history independently predicted severe CAD after adjustment for age, sex, hypertension, diabetes, dyslipidemia, and smoking (adjusted OR 1.58; 95% CI 1.15–2.16; p=0.01).

Conclusion: Maternal CAD history was associated with greater angiographic severity and poorer left ventricular systolic function than paternal history. Incorporating sex-specific parental history into cardiovascular risk assessment may improve early identification of high-risk individuals.