Lindgren Magnus P, Smith J Gustav, Li Xinjun, Sundquist Jan, Sundquist Kristina, Zöller Bengt
Center for Primary Health Care Research, Lund University and Region Skåne, Malmö, Sweden.
Molecular Epidemiology and Cardiology, Department of Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
Int J Cardiol. 2016 Nov 15;223:379-384. doi: 10.1016/j.ijcard.2016.08.067. Epub 2016 Aug 6.
The familial risks of heart failure (HF) remain largely undetermined. This nationwide follow-up study aimed at determining risk of hospitalization for HF conferred by affected siblings.
Swedish Multi-generation Register data, with records of at least one full sibling available at start of follow-up, were linked to the Hospital Discharge Register data for 1987-2010. The oldest participants were aged 78years in 2010. Relative risks, standardized incidence ratios (SIRs), of HF hospitalization were calculated for individuals with siblings hospitalized with HF compared with those whose siblings were not. Adjustments were made for common HF comorbidities, age, time period, socioeconomic status and region. During the 24year follow-up (1987-2010) 23,212 individuals (7155 females), were hospitalized because of HF. From this total, 1121 had at least one full sibling hospitalized for HF. Sibling risks were generally similar for males and females. The SIR of HF hospitalization was 1.62 (95% confidence interval 1.54-1.70) for individuals with one affected sibling and 15.46 (12.82-18.50) for individuals with two affected siblings. The SIR conferred by one or more affected siblings was 2.67 (2.24-3.16) below the age of 50years, 1.92 (1.75-2.10) between 50 and 59years of age, 1.63 (1.52-1.76) between 60 and 69years of age, and 1.54 (1.38-1.71) between 70 and 78years of age. Spouses had low familial risks: SIR=1.04 (1.03-1.06).
Familial factors are important risk factors in HF, with particularly high risks among individuals with two or more affected siblings and in early onset of HF.
心力衰竭(HF)的家族风险在很大程度上仍未确定。这项全国性的随访研究旨在确定受影响的兄弟姐妹所带来的HF住院风险。
瑞典多代登记数据(在随访开始时至少有一个同胞的记录)与1987 - 2010年的医院出院登记数据相链接。2010年最年长的参与者年龄为78岁。计算了兄弟姐妹因HF住院的个体与兄弟姐妹未因HF住院的个体相比的HF住院相对风险、标准化发病率(SIR)。对常见的HF合并症、年龄、时间段、社会经济地位和地区进行了调整。在24年的随访期间(1987 - 2010年),有23212人(7155名女性)因HF住院。其中,1121人至少有一个同胞因HF住院。男性和女性的兄弟姐妹风险总体相似。有一个受影响同胞的个体HF住院SIR为1.62(95%置信区间1.54 - 1.70),有两个受影响同胞的个体为15.46(12.82 - 18.50)。一个或多个受影响同胞带来的SIR在50岁以下为2.67(2.24 - 3.16),50至59岁为1.92(1.75 - 2.10),60至69岁为1.63(1.52 - 1.76),70至78岁为1.54(1.38 - 1.71)。配偶的家族风险较低:SIR = 1.04(1.03 - 1.06)。
家族因素是HF的重要风险因素,在有两个或更多受影响同胞的个体以及HF早期发病中风险尤其高。