Sindet-Pedersen Caroline, Bruun Oestergaard Louise, Gundlund Anna, Fosbøl Emil Loldrup, Aasbjerg Kristian, Langtved Pallisgaard Jannik, Gislason Gunnar, Torp-Pedersen Christian, Bjerring Olesen Jonas
Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.
PLoS One. 2016 Dec 29;11(12):e0169055. doi: 10.1371/journal.pone.0169055. eCollection 2016.
Identification of risk factors for venous thromboembolism (VTE) is of utmost importance to improve current prophylactic regimes and treatment guidelines. The extent to which a family history contributes to the risk of VTE needs further exploration.
To examine the relative rate of VTE in first-degree relatives compared with the general population.
By crosslinking Danish nationwide registries we identified patients with VTE between 1978 and 2012, and their familial relations. The first member in a family to acquire VTE was defined as the proband. All first-degree relatives to probands were followed from the VTE date of the proband and until an event (VTE), death, emigration, 100 year birthday or end of study: 31st of December 2012, whichever came first. The relative rate of VTE was estimated by standardized incidence ratios (SIR) using time-dependent Poisson regression models, with the general population as a fixed reference.
We identified 70,767 children of maternal probands, 66,065 children of paternal probands, and 29,183 siblings to sibling probands. Having a maternal proband or a paternal proband were associated with a significantly increased VTE rate of 2.15 (CI: 2.00-2.30) and 2.06 (CI: 1.92-2.21), respectively. The highest estimate of VTE was observed among siblings (adjusted SIR of 2.60 [CI: 2.38-2.83]). Noteworthy, the rate of VTE increased for all first-degree relatives when the proband was diagnosed with VTE in a young age (≤ 50 years).
A family history of VTE was associated with a significantly increased rate of VTE among first-degree relatives compared with the general population.
识别静脉血栓栓塞症（VTE）的危险因素对于改进当前的预防方案和治疗指南至关重要。家族史对VTE风险的影响程度有待进一步探究。
研究一级亲属中VTE的相对发生率与普通人群的比较情况。
通过关联丹麦全国登记处的数据，我们确定了1978年至2012年间患有VTE的患者及其家族关系。家族中首个患VTE的成员被定义为先证者。所有先证者的一级亲属从先证者发生VTE之日起开始随访，直至发生事件（VTE）、死亡、移民、年满100岁或研究结束（2012年12月31日），以先发生者为准。使用时间依赖性泊松回归模型，以普通人群作为固定参照，通过标准化发病率比（SIR）估计VTE的相对发生率。
我们确定了70767名母亲先证者的子女、66065名父亲先证者的子女以及29183名同胞先证者的兄弟姐妹。有母亲先证者或父亲先证者分别与VTE发生率显著升高相关，分别为2.15（CI：2.00 - 2.30）和2.06（CI：1.92 - 2.21）。在兄弟姐妹中观察到最高的VTE估计值（调整后的SIR为2.60 [CI：2.38 - 2.83]）。值得注意的是，当先证者在年轻时（≤50岁）被诊断为VTE时，所有一级亲属的VTE发生率均升高。
与普通人群相比，VTE家族史与一级亲属中VTE发生率显著升高相关。
