Zheng Xiaowei, Zeng Nimei, Wang Aili, Zhu Zhengbao, Peng Hao, Zhong Chongke, Xu Tan, Xu Tian, Peng Yanbo, Li Qunwei, Ju Zhong, Geng Deqin, Zhang Yonghong, He Jiang
a Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases , Medical College of Soochow University , Suzhou , China.
b Department of Epidemiology , Tulane University School of Public Health and Tropical Medicine , New Orleans , LA , USA.
Neurol Res. 2019 May;41(5):466-472. doi: 10.1080/01616412.2019.1577342. Epub 2019 Mar 4.
The association between family history of stroke and clinical outcomes after ischemic stroke remains unclear.
A total of 3878 acute ischemic stroke patients from CATIS were included. The participants with ischemic stroke were divided into groups according to types of family history of stroke, stroke onset age and stroke subtypes. The primary outcome was a composite outcome of death and vascular events within 1 year after stroke. Multivariable Cox proportional hazard models were used to analyze the association between family history of stroke and other variables and clinical outcomes.
Among 3878 ischemic stroke patients, 708 (18.26%) had a history of stroke in their first-degree relatives and 399 experienced a composite outcome (172 patients died and 227 experienced vascular events) within 1 year after stroke. Overall family history was not associated with the primary outcome (HR, 1.08; 95% CI, 0.37-3.19). However, the patients with maternal stroke history (HR, 1.87; 95% CI, 1.31-2.97), stroke onset age<55 years with family history (HR, 2.02; 95% CI, 1.08-3.80) and thrombotic stroke in the patients with family history (HR, 1.46; 95% CI, 1.00-2.12) were associated with primary outcome, death and vascular events, respectively.
This study suggests that maternal stroke history, age<55 years at stroke onset and thrombotic stroke in the patients with a family history are associated with poor outcomes after stroke. Further studies from other samples are needed to replicate our findings due to a reason for excluding some severe stroke patients in this study.
缺血性卒中后，卒中家族史与临床结局之间的关联仍不明确。
纳入了来自CATIS的3878例急性缺血性卒中患者。根据卒中家族史类型、卒中发病年龄和卒中亚型，将缺血性卒中参与者进行分组。主要结局是卒中后1年内死亡和血管事件的复合结局。采用多变量Cox比例风险模型分析卒中家族史与其他变量及临床结局之间的关联。
在3878例缺血性卒中患者中，708例（18.26%）一级亲属有卒中病史，399例在卒中后1年内出现复合结局（172例患者死亡，227例发生血管事件）。总体家族史与主要结局无关（HR，1.08；95%CI，0.37 - 3.19）。然而，有母亲卒中病史的患者（HR，1.87；95%CI，1.31 - 2.97）、发病年龄<55岁且有家族史的患者（HR，2.02；95%CI，1.08 - 3.80）以及有家族史的患者中的血栓形成性卒中（HR，1.46；95%CI，1.00 - 2.12）分别与主要结局、死亡和血管事件相关。
本研究表明，母亲卒中病史、卒中发病年龄<55岁以及有家族史患者中的血栓形成性卒中与卒中后不良结局相关。由于本研究排除了一些重症卒中患者，因此需要其他样本的进一步研究来重复我们的发现。
