Stroke: Stroke patients, family members at increased risk of death

Stroke is the leading cause of morbidity and death worldwide
.

Several modifiable risk factors for stroke have been identified, such as high blood pressure, smoking, diabetes, hyperlipidemia and physical inactivity are also significant risks

Such as high blood pressure, smoking, diabetes, hyperlipidemia and physical inactivity are also important risks

A family history of ischemic stroke (IS) has also been shown to be associated with an increased risk of IS, thus suggesting a genetic factor
.

More recently, genetic studies have identified an increasing number of single-gene disorders and common variants associated with stroke

However, the extent to which familial and possibly genetic factors influence the prognosis of IS is largely unknown
.

Several factors have been described as being associated with stroke survival, such as age, stroke severity, female gender, cancer, coronary heart disease, diabetes, chronic obstructive pulmonary disease (COPD), high cholesterol, anemia, homocysteinemia, and Serum creatine is elevated

Age, stroke severity, female gender, cancer, coronary heart disease, diabetes, chronic obstructive pulmonary disease (COPD), high cholesterol, anemia, homocysteinemia, and elevated serum creatine

Currently, no studies have assessed the familial prognosis of IS
.

In this nationwide sibling study, Bengt Zöller et al at Skåne University Hospital determined the impact of poor IS survival among family members (siblings) on the prognosis of patients with IS

Linking data from a nationwide registry in Sweden, they identified 1,380 pairs of Swedish-born siblings (2,760 cases), all of whom were hospitalized for IS for the first time between 1991 and 2010
.

The median age was 62 years (range 26-78 years)

Familial hazard ratios (FHRs) for mortality after first IS hospitalization were determined using Cox regression
.

The effects of relative survival after IS were classified 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, length of hospital stay, and comorbidities
.

They found that: Shorter sibling survival (ie, <3 or <4 years) after IS was associated with adjusted FHR, with overall mortality after IS of 1.
29 (95% CI, 1.
05-1.
58) and 1.
24 (95%), respectively.
%CI, 1.
02-1.
51)
.

Stratified analysis showed that shorter sibling survival (ie, <2-5 years) was stronger and more meaningful only in younger individuals (<62 years) and males
.

Shorter sibling survival (i.
e.
<2-5 years) is stronger and more meaningful only in younger individuals (<62 years) and males

The highest FHR for shorter 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 younger male subjects, the 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, length of hospital stay, coronary heart disease, diabetes, dementia, heart failure, obesity, alcoholism, and hyperlipidemia

Mortality was also associated with sex, education, age at onset, year of diagnosis, length of hospital stay, coronary heart disease, diabetes, dementia, heart failure, obesity, alcoholism, and hyperlipidemia

Family history of short sibling survival after IS is associated with mortality after IS in young male subjects

 

Original source:
Zöller B, Pirouzifard M, Lindgren MP, Sundquist J, Sundquist K.
Familial Mortality Risks in Patients With Ischemic Stroke: A Swedish Sibling Study.
Stroke.
Published online February 2, 2022:STROKEAHA.
121.
035669.
doi:10.
1161/STROKEAHA .
121.
035669

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