Center for Primary Health Care Research, CRC, Skåne University Hospital, Building 28, Floor 11, Jan Waldenströms gata 35, Malmö, S-205 02, Sweden.
BMC Cardiovasc Disord. 2012 Dec 10;12:121. doi: 10.1186/1471-2261-12-121.
Although the heritability of atrial fibrillation (AF) has been determined, the relevance of family history of AF for the likelihood of recurrent hospitalization for AF is unknown. The aim of this nationwide study was to determine whether family history of AF is a risk factor of recurrent hospitalization for lone AF (LAF), i.e., AF with unknown etiology. The familial risk for first time LAF hospitalization was also determined and compared to the risk of recurrent hospitalization for LAF.
We examined whether family history of AF is a risk factor for recurrent hospitalization for LAF in the whole Swedish population. We linked Multigeneration Register data on individuals aged 0-60 years to Hospital Discharge Register data for the period 1987-2009 to compare LAF recurrent hospitalization risk among individuals with and without parental or sibling history of AF. We calculated hazard ratios (HRs) to determine the familial HR of recurrent hospitalization for LAF. Odds ratios (OR) were calculated for familial risk of first time LAF hospitalization.
The risk of recurrent LAF hospitalization was 1.23 (95% CI 1.17-1.30) for individuals with affected parents compared to 1.30 (95% CI 1.22-1.38) for those with affected siblings. After 10 years of follow up 50% of those without and 60% of those with family history had recurrent hospitalization for LAF. The risk of recurrent LAF hospitalization in individuals with two affected parents was 1.65 (95% CI 1.44-1.90). There was an interaction between age and family history, with family history having a weaker effect on LAF hospitalization risk in older age groups. The OR for first time LAF hospitalization was 2.08 (95% CI 2.02-2.15) for offspring with affected parents and 3.23 (95% CI 3.08-3.39) for individuals with affected siblings.
Family history of AF is a novel risk factor for recurrent LAF hospitalization. The higher recurrence hospitalization risk in multiplex families and younger individuals suggests a genetic contribution. However, the familial risk for recurrent LAF hospitalization was much lower than the risk for first time LAF hospitalization, suggesting that familial and possibly genetic factors are more important for first time LAF hospitalization than recurrent LAF hospitalization.
尽管已经确定了心房颤动（AF）的遗传性，但家族史对 AF 复发性住院的相关性尚不清楚。本项全国性研究的目的是确定 AF 家族史是否是孤立性 AF（即病因不明的 AF）复发性住院的危险因素。还确定了首次孤立性 AF 住院的家族风险，并将其与孤立性 AF 复发性住院的风险进行了比较。
我们研究了 AF 家族史是否是全瑞典人群中孤立性 AF 复发性住院的危险因素。我们将年龄在 0-60 岁的个体的多代登记数据与 1987-2009 年的住院患者出院登记数据相链接，以比较有和无父母或兄弟姐妹 AF 病史的个体中孤立性 AF 复发性住院的风险。我们计算了危险比（HR）以确定孤立性 AF 复发性住院的家族 HR。计算了首次孤立性 AF 住院的家族风险的比值比（OR）。
与无家族史的个体相比，父母患病的个体孤立性 AF 复发性住院的风险为 1.23（95%CI 1.17-1.30），兄弟姐妹患病的个体为 1.30（95%CI 1.22-1.38）。10 年的随访后，无家族史的个体中有 50%和有家族史的个体中有 60%发生孤立性 AF 复发性住院。有两名患病父母的个体孤立性 AF 复发性住院的风险为 1.65（95%CI 1.44-1.90）。年龄与家族史之间存在交互作用，家族史对年龄较大的年龄组的孤立性 AF 住院风险的影响较弱。父母患病的后代首次孤立性 AF 住院的 OR 为 2.08（95%CI 2.02-2.15），兄弟姐妹患病的个体为 3.23（95%CI 3.08-3.39）。
AF 家族史是孤立性 AF 复发性住院的新危险因素。多聚家族和年轻个体中更高的复发性住院风险提示遗传因素的作用。然而，孤立性 AF 复发性住院的家族风险远低于首次孤立性 AF 住院的风险，这表明家族和可能的遗传因素对首次孤立性 AF 住院比孤立性 AF 复发性住院更为重要。
