多核心家庭中心房颤动/心房扑动的家族高风险：瑞典全国性家族研究。
High familial risk of atrial fibrillation/atrial flutter in multiplex families: a nationwide family study in Sweden.
机构信息
Center for Primary Health Care Research, Region Skåne/Lund University, Malmö, Sweden.
出版信息
J Am Heart Assoc. 2012 Dec 31;2(1):e003384. doi: 10.1161/JAHA.112.003384.
BACKGROUND
Although the heritability of atrial fibrillation/atrial flutter (AF/AFl) has been determined, the familial risk in multiplex families is unclear. The main aim of this nationwide study was to determine the familial risk of AF/AFl in multiplex families.
METHODS AND RESULTS
We examined the familial risk of AF/AFl in the entire Swedish population. We linked Multigeneration Register data on individuals aged 0 to 76 years with Hospital Discharge Register data for 1987-2008 and Outpatient Register data for 2001-2008 to compare AF/AFl risk among relatives of all 300 586 individuals with AF/AFl with that among relatives of unaffected individuals. We used conditional logistic regression to investigate differences in exposure between cases and controls. Parents (odds ratio [OR] 1.95 [95% CI 1.89 to 2.00]) and siblings (OR=3.08 [3.00 to 3.16]) of cases had higher odds of AF/AFl than did parents and siblings of controls. AF/AFl ORs were increased in both sexes. For 2% of cases, both parents had AF/AFl, compared with only 0.7% of controls (OR=3.60 [3.30 to 3.92]). Moreover, 3% of cases had ≥2 siblings with AF/AFl, compared with 1% of controls (OR=5.72 [5.28 to 6.19]). In premature cases (diagnosed at age <50 years), the ORs were 5.04 (4.36 to 5.82) and 8.51 (6.49 to 11.15) for AF/AFl in both parents and AF/AFl in ≥2 siblings, respectively. The overall spouse OR was 1.16 (1.13 to 1.19).
CONCLUSIONS
Family history of AF/AFl increases the odds of AF/AFl in first-degree relatives. High familial risks were observed in multiplex families.
背景
尽管已经确定了心房颤动/心房扑动（AF/AFl）的遗传性，但多聚家庭中的家族风险尚不清楚。本全国性研究的主要目的是确定多聚家庭中 AF/AFl 的家族风险。
方法和结果
我们检查了整个瑞典人群中 AF/AFl 的家族风险。我们将多代登记处数据与 1987 年至 2008 年的住院登记处数据以及 2001 年至 2008 年的门诊登记处数据相关联，以比较 300586 例 AF/AFl 患者的亲属的 AF/AFl 风险与未受影响个体的亲属的风险。我们使用条件逻辑回归来研究病例和对照之间暴露的差异。病例的父母（比值比[OR] 1.95 [95%置信区间 1.89 至 2.00]）和兄弟姐妹（OR=3.08 [3.00 至 3.16]）发生 AF/AFl 的可能性高于对照的父母和兄弟姐妹。两性的 AF/AFl OR 均升高。在 2%的病例中，父母双方均患有 AF/AFl，而对照组中只有 0.7%（OR=3.60 [3.30 至 3.92]）。此外，3%的病例有≥2 个患有 AF/AFl 的兄弟姐妹，而对照组中只有 1%（OR=5.72 [5.28 至 6.19]）。在早发性病例（诊断年龄<50 岁）中，父母双方均患有 AF/AFl 和≥2 个兄弟姐妹均患有 AF/AFl 的 OR 分别为 5.04（4.36 至 5.82）和 8.51（6.49 至 11.15）。总体配偶 OR 为 1.16（1.13 至 1.19）。
结论
AF/AFl 的家族史会增加一级亲属发生 AF/AFl 的几率。在多聚家庭中观察到高家族风险。
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