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Chung JW, Kim BJ, Han MK, Kang K, Park JM, Park SS, Park TH, Cho YJ, Hong KS, Lee KB, Kim JG, Ko Y, Lee S, Nah HW, Kim DH, Cha JK, Oh MS, Yu KH, Lee BC, Jang MS, Lee JS, Lee J, Bae HJ. Family History and Risk of Recurrent Stroke. Stroke 2016; 47:1990-6. [DOI: 10.1161/strokeaha.116.013148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/13/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The association between family history of stroke and stroke recurrence remains unclear.
Methods—
Using a web-based multicenter stroke registry database, information on history of stroke in first-degree relatives was collected prospectively for acute ischemic stroke patients who were hospitalized within 7 days of onset. The collected information was categorized as follows: type of the affected relative(s) with stroke (paternal, maternal, sibling, or 2 or more) and age of the relative’s stroke onset (<50, 50–59, 60–69, and ≥70 years). Stroke recurrence was captured prospectively using a predetermined protocol. Subgroup analyses were performed according to the patient’s age at the index stroke.
Results—
Among 7642 patients, 937 (12.3%) had a history of stroke in their first-degree relatives and 475 (6.2%: 201 within and 274 after 3 weeks from index stroke) experienced stroke recurrence (median follow-up, 365 days). In multivariable Cox proportional hazard models, overall family history was not associated with stroke recurrence (hazard ratio, 1.08; 95% confidence interval, 0.81–1.43). However, the details of their family histories, including relative’s age at stroke onset (<50 years: hazard ratio, 2.14; 95% confidence interval, 1.004–4.54) and stroke history in a sibling (hazard ratio, 1.67; 95% confidence interval, 1.09–2.58), were independently associated with stroke recurrence after adjusting for potential confounders. The associations appeared to be stronger in young adults with stroke (age, <55 years) than in older stroke patients.
Conclusions—
This study suggests that elevated risks of recurrent stroke are associated with having relatives with early-onset stroke and siblings with stroke histories, implying that additional precautions may be needed in such populations.
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Affiliation(s)
- Jong-Won Chung
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Beom Joon Kim
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Moon-Ku Han
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Kyusik Kang
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Jong-Moo Park
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Sang-Soon Park
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Tai Hwan Park
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Yong-Jin Cho
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Keun-Sik Hong
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Kyung Bok Lee
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Jae Guk Kim
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Youngchai Ko
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - SooJoo Lee
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Hyun-Wook Nah
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Dae-Hyun Kim
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Jae-Kwan Cha
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Mi-Sun Oh
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Kyung-Ho Yu
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Byung-Chul Lee
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Myung Suk Jang
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Ji Sung Lee
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Juneyoung Lee
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
| | - Hee-Joon Bae
- From the Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-W.C.); Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea (B.J.K., M.-K.H., M.S.J.); Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea (K.K., J.-M.P.); Department of Neurology, Seoul Medical Center, Republic of Korea (S.-S.P., T.H.P.); Department of Neurology,
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An G, Du Z, Meng X, Guo T, Li G, Chen Y, Li J, An F, Zhang Y, Li W, Zhang C. Risk factors for long-term outcome of drug-eluting stenting in adults with early-onset coronary artery disease. Int J Med Sci 2014; 11:721-5. [PMID: 24904227 PMCID: PMC4045791 DOI: 10.7150/ijms.8718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 04/21/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We lack data on the long-term outcome of drug-eluting stenting in patients with early-onset coronary artery disease (CAD). Here, we investigated the association of traditional risk factors and major adverse cardiovascular events (MACEs) after drug-eluting stenting in patients with CAD who were < 50 years old. METHODS We enrolled 437 consecutive CAD patients < 50 years old who underwent drug-eluting stenting and 132 subjects who were age- and sex-matched and angiographically shown to be disease free as controls. MACEs were analyzed in CAD patients for a median of 24 months [interquartile range 14-34 months]. RESULTS Male patients accounted for 90.4% of cases. As compared with controls, patients with early-onset CAD had higher body mass index and rates of smoking, family history of CAD, and diabetes and hypercholesterolemia. During the hospital stay, 1 patient died, and the incidence of MACEs was 1.1%. At the end of follow-up, the overall death rate was 0.7%. MACEs were observed in 54 patients (12.4%). On Cox proportional hazard analyses, positive family history and diabetes were independent risk factors of MACEs (HR 2.61, 95% confidence interval 1.29-4.00, p = 0.002; and HR 2.48, 95% confidence interval 0.86-3.14, p = 0.004, respectively). CONCLUSIONS Drug-eluting stenting is a reliable treatment for patients with early-onset CAD. Positive family history of CAD and diabetes are independent risk factors of adverse cardiovascular events in this subgroup of patients after drug-eluting stent implantation.
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Affiliation(s)
- Guipeng An
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Zhongqi Du
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Xiao Meng
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Tao Guo
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Guishuang Li
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Yuguo Chen
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Jifu Li
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Fengshuang An
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Yun Zhang
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
| | - Wenjing Li
- 3. Fine Arts School of Shandong University, Jinan, Shandong 250012, China
| | - Cheng Zhang
- 1. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
- 2. Department of cardiology, Shandong University Qilu Hospital, Jinan, Shandong 250012, China
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