Wahrenberg A, Kuja‐Halkola R, Magnusson PKE, et al. - In this study, family history of early‐onset atherosclerotic cardiovascular disease (ASCVD) was not only found to be linked with recurrent ASCVD post- myocardial infarction, independently of conventional risk factors, but also enhanced secondary risk prediction. This could unveil cases to target for intensified secondary prophylaxis.

• This study involved 25,615 patients from the nationwide myocardial infarction registry in Sweden, SWEDEHEART, and the participants were observed from their 1‐year revisit after a first‐time myocardial infarction during 2005 to 2013, until December 31, 2018.

• Family history of early‐onset ASCVD in ≥1 first‐degree relative was evident in 2.3% and was found to be related to recurrent ASCVD (hazard ratio [HR] 1.31), fully adjusted for risk factors (HR, 1.22).

• Specifically, a 22% elevated risk of recurrent ASCVD after a first myocardial infarction was noted in patients with a family history of early‐onset ASCVD in at least 1 first‐degree relative, vs those without such family history, independently of other traditional risk factors.

• Improvement in the discriminatory ability of a validated risk prediction score for recurrent ASCVD was achieved with the addition of family history of early‐onset ASCVD in at least 1 first‐degree relative; this could improve risk prediction in a secondary prevention setting, where intrinsic risk is already high.