Coronary Artery disease SCreening in young ADult relativEs of individuals with premature Myocardial Infarction (CASCADE-MI study)

INTERVENTION: CT coronary angiography plus routine cardiovascular risk factor assessment. ‐ CT coronary angiography will be performed at an accredited centre and typically will involve less than 1 hour of the participants time. An intravenous cannula will be required for iodinated contrast to be administered during the scan. ‐ The routine cardiovascular risk factor assessment will be performed over 15‐30 minutes clinic by a Cardiologist and will involve a clinical assessment of risk factors, medications, physical exam findings, blood tests and calculation of risk using the Australian CVD risk calculator. CONDITION: Cardiovascular ‐ Coronary heart disease Myocardial infarction;Coronary artery disease;Risk factors; ; Myocardial infarction ; Coronary artery disease ; Risk factors PRIMARY OUTCOME: Difference in low‐density lipoprotein cholesterol (LDL‐C) level at 1 year between the two arms[Blood test for lipid profile 1 year follow‐up] SECONDARY OUTCOME: Burden of coronary artery disease on computed tomography coronary angiography in adult family members of individuals with premature MI.[Computed tomography coronary angiography Baseline (at single screening assessment)] Cardiovascular risk factor profile in adult family members of individuals with premature MI.[Risk factor assessment in clinic Baseline (at single screening assessment)] Cost‐effectiveness of computed tomography coronary angiography for screening in this cohort.[Costs of the scan and preventive medication use will be analysed and compared with projected cardiovascular risk and potential risk reduction. Data will be collected from audit of patient electronic medical records, interview with patient or from medication prescription records by GP. 1 year post‐screening] Difference in use of preventive medications (i.e., statins) between two arms.[Interview with patient or medication prescription records by GP 3 months and 1 year post‐screening] Differences in adherence to healthy lifestyle between two arms.[Questionnaire including the World Health Organisation Global Physical Activity Questionnaire 3 months and 1 year post‐screening] INCLUSION CRITERIA: Apparently healthy first‐degree relative aged 30 to 55 years of a patient with myocardial infarction at premature age (<55 years).