Si J H, Meng R R, Yu C Q, Guo Y, Bian Z, Tan Y L, Pei P, Chen J S, Chen Z M, Lyu J, Li L M
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Chinese Academy of Medical Sciences, Beijing 100010, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Feb 10;39(2):173-178. doi: 10.3760/cma.j.issn.0254-6450.2018.02.007.
To evaluate the association of family history with risk of major coronary events (MCE) and ischemic heart disease (IHD). After excluding participants with heart disease, stroke or cancer at baseline survey, a total of 485 784 participants from the China Kadoorie Biobank, who had no missing data on critical variables, were included in the analysis. Cox regression analysis was used to estimate the hazard ratios () and 95% . Subgroup analyses were performed according to the baseline characteristics. During a median of 7.2 years of follow-up, we documented 3 934 incident cases of MCE and 24 537 cases of IHD. In multivariable-adjusted models, family history was significantly associated with risk of MCE and IHD. The adjusted (95%) were 1.41 (1.19-1.65) and 1.25 (1.18-1.33), respectively. History of disease among siblings was more strongly associated with early-onset MCE than parental history (=2.97, 95%: 1.80-4.88). Moreover, the association of family history with MCE and IHD was stronger in persons who were overweight or obesive, and the association between family history and MEC was stronger in smokers. This large-scale, prospective study indicated that family history was an independent risk factor for MCE and IHD in China. The intervention targeting major known lifestyle risk factors and the management of chronic diseases should be strengthened for Chinese population, especially for the individuals with family history were at high risk.
评估家族史与主要冠状动脉事件（MCE）及缺血性心脏病（IHD）风险之间的关联。在基线调查中排除患有心脏病、中风或癌症的参与者后，来自中国嘉道理生物银行的485784名参与者被纳入分析，这些参与者在关键变量上没有缺失数据。采用Cox回归分析来估计风险比（HR）及95%置信区间。根据基线特征进行亚组分析。在中位随访7.2年期间，我们记录了3934例MCE事件和24537例IHD病例。在多变量调整模型中，家族史与MCE和IHD风险显著相关。调整后的HR（95%置信区间）分别为1.41（1.19 - 1.65）和1.25（1.18 - 1.33）。兄弟姐妹的疾病史比父母的疾病史与早发性MCE的关联更强（P = 2.97，95%置信区间：1.80 - 4.88）。此外，家族史与MCE和IHD的关联在超重或肥胖者中更强，家族史与MEC的关联在吸烟者中更强。这项大规模前瞻性研究表明，家族史是中国人群中MCE和IHD的独立危险因素。对于中国人群，尤其是有家族史的高危个体，应加强针对主要已知生活方式危险因素的干预和慢性病管理。
