Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Familial Mortality Risks in Patients with Ischemic Stroke : A Swedish Sibling Study

Zöller, Bengt LU orcid ; Pirouzifard, Mir Nabi LU ; Lindgren, Magnus P. LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2022) In Stroke 53(5). p.1615-1623
Abstract

Background: The influence of familial factors on the prognosis of ischemic stroke (IS) is unknown. This nationwide follow-up study evaluated familial mortality risks of IS among Swedish sibling pairs hospitalized for IS. Methods: We linked Swedish nationwide registers for the identification of 1380 Swedish born sibling pairs (2760 cases), where both siblings were hospitalized for first-time IS between 1991 and 2010. Median age was 62 years (range, 26-78 years). Sibling pairs with cancer were excluded. Familial hazard ratios (FHRs) for mortality after first IS hospitalization were determined with Cox regression. The influence of proband survival after IS was categorized as short sibling survival (<1, 2, 3, 4, or 5 years) or long... (More)

Background: The influence of familial factors on the prognosis of ischemic stroke (IS) is unknown. This nationwide follow-up study evaluated familial mortality risks of IS among Swedish sibling pairs hospitalized for IS. Methods: We linked Swedish nationwide registers for the identification of 1380 Swedish born sibling pairs (2760 cases), where both siblings were hospitalized for first-time IS between 1991 and 2010. Median age was 62 years (range, 26-78 years). Sibling pairs with cancer were excluded. Familial hazard ratios (FHRs) for mortality after first IS hospitalization were determined with Cox regression. The influence of proband survival after IS was categorized as short sibling survival (<1, 2, 3, 4, or 5 years) or long sibling survival (≥1, 2, 3, 4, or 5 years) after IS. FHRs were adjusted for age at onset, sex, education, county, year of diagnosis, days of hospitalization, and comorbidities. Results: Short sibling survival (ie, <3 or <4 years) after IS was associated with an adjusted FHR of 1.29 (95% CI, 1.05-1.58) and 1.24 (95% CI, 1.02-1.51), respectively, for overall mortality after IS. Stratified analysis showed that short sibling survival (ie, <2 - <5 years) was stronger and significant only among younger individuals (<62 years) and males. Highest FHR for short sibling survival (ie, <4 years) was 1.42 (95% CI, 1.08-1.88) for younger individuals and 1.50 (95% CI, 1.21-1.87) for males. For young male subjects, FHR was 1.80 (95% CI, 1.33-2.46). In the adjusted model, mortality was also associated with sex, education, age at onset, year of diagnosis, days of hospitalization, coronary heart disease, diabetes, dementia, heart failure, obesity, alcoholism, and hyperlipidemia. Conclusions: Our results suggest that family history of short survival in siblings after IS is associated with mortality after IS for younger male subjects. Additional studies are needed to characterize possible genetic and nongenetic familial environmental causes of this association.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, genetics, ischemic stroke, mortality, prognosis, siblings, stroke
in
Stroke
volume
53
issue
5
pages
9 pages
publisher
American Heart Association
external identifiers
  • scopus:85129331577
  • pmid:35105184
ISSN
0039-2499
DOI
10.1161/STROKEAHA.121.035669
language
English
LU publication?
yes
id
a87e0115-bac6-4b13-ae93-0138a60104a6
date added to LUP
2022-07-06 15:34:09
date last changed
2024-05-30 09:08:30
@article{a87e0115-bac6-4b13-ae93-0138a60104a6,
  abstract     = {{<p>Background: The influence of familial factors on the prognosis of ischemic stroke (IS) is unknown. This nationwide follow-up study evaluated familial mortality risks of IS among Swedish sibling pairs hospitalized for IS. Methods: We linked Swedish nationwide registers for the identification of 1380 Swedish born sibling pairs (2760 cases), where both siblings were hospitalized for first-time IS between 1991 and 2010. Median age was 62 years (range, 26-78 years). Sibling pairs with cancer were excluded. Familial hazard ratios (FHRs) for mortality after first IS hospitalization were determined with Cox regression. The influence of proband survival after IS was categorized as short sibling survival (&lt;1, 2, 3, 4, or 5 years) or long sibling survival (≥1, 2, 3, 4, or 5 years) after IS. FHRs were adjusted for age at onset, sex, education, county, year of diagnosis, days of hospitalization, and comorbidities. Results: Short sibling survival (ie, &lt;3 or &lt;4 years) after IS was associated with an adjusted FHR of 1.29 (95% CI, 1.05-1.58) and 1.24 (95% CI, 1.02-1.51), respectively, for overall mortality after IS. Stratified analysis showed that short sibling survival (ie, &lt;2 - &lt;5 years) was stronger and significant only among younger individuals (&lt;62 years) and males. Highest FHR for short sibling survival (ie, &lt;4 years) was 1.42 (95% CI, 1.08-1.88) for younger individuals and 1.50 (95% CI, 1.21-1.87) for males. For young male subjects, FHR was 1.80 (95% CI, 1.33-2.46). In the adjusted model, mortality was also associated with sex, education, age at onset, year of diagnosis, days of hospitalization, coronary heart disease, diabetes, dementia, heart failure, obesity, alcoholism, and hyperlipidemia. Conclusions: Our results suggest that family history of short survival in siblings after IS is associated with mortality after IS for younger male subjects. Additional studies are needed to characterize possible genetic and nongenetic familial environmental causes of this association.</p>}},
  author       = {{Zöller, Bengt and Pirouzifard, Mir Nabi and Lindgren, Magnus P. and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0039-2499}},
  keywords     = {{epidemiology; genetics; ischemic stroke; mortality; prognosis; siblings; stroke}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1615--1623}},
  publisher    = {{American Heart Association}},
  series       = {{Stroke}},
  title        = {{Familial Mortality Risks in Patients with Ischemic Stroke : A Swedish Sibling Study}},
  url          = {{http://dx.doi.org/10.1161/STROKEAHA.121.035669}},
  doi          = {{10.1161/STROKEAHA.121.035669}},
  volume       = {{53}},
  year         = {{2022}},
}