Myocardial infarction in parents who lost a child - A nationwide prospective cohort study in Denmark
Myocardial infarction in parents who lost a child - A nationwide prospective cohort study in Denmark
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DOI：
10.1161/01.cir.0000031569.45667.58
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发表时间：
2002-09-24
期刊：
影响因子：
37.8
通讯作者：
Olsen, J
中科院分区：
文献类型：
--
作者：
Li, J;Hansen, D;Olsen, J
背景——心理压力与冠心病之间的关联仍不明确。我们基于国家登记册进行了一项前瞻性随访研究，以调查孩子死亡（最严重的压力源之一）是否会增加父母患心肌梗死（MI）的风险。
方法与结果——1980年至1996年，丹麦19361名失去孩子（<18岁）的父母被纳入暴露队列，295540名家庭结构匹配的父母被选入未暴露队列。采用Cox比例风险模型评估心肌梗死（MI）的相对风险（RR）。暴露组致命性心肌梗死和任何首次心肌梗死的平均RR分别为1.36（95%置信区间，0.98 - 1.88）和1.28（95%置信区间，1.08 - 1.51）。在随访的前6年，两组的心肌梗死风险相似。从随访的第7年到第17年，暴露队列致命性心肌梗死的RR为1.58（95%置信区间，1.08 - 2.30），首次心肌梗死的RR为1.31（95%置信区间，1.09 - 1.57）。意外失去孩子的父母，尤其是因婴儿猝死综合征失去孩子的父母，RR更高。
结论——孩子的死亡与丧子父母患心肌梗死的风险增加有关。
Background-The association between psychological stress and coronary heart disease remains unclear. We conducted a prospective follow-up study based on national registers to investigate if the death of a child, one of the most severe stressors, increases the risk of myocardial infarction (MI) in parents.Methods and Results-From 1980 to 1996, 19 361 parents who lost a child (< 18 years of age) in Denmark were recruited to the exposed cohort, and 295 540 parents matched on family structure were selected for the unexposed cohort. The Cox proportional hazards model was used to evaluate the relative risk (RR) of myocardial infarction (MI). The average RRs for a fatal MI and any first MI among the exposed were 1.36 (95% CI, 0.98 to 1.88) and 1.28 (95% CI, 1.08 to 1.51), respectively. The two cohorts had similar MI risk during the first 6 years of follow-up. From the 7th to the 17th year of follow-up, the exposed cohort had a RR of 1.58 (95% CI, 1.08 to 2.30) for fatal MI and a RR of 1.31 (95% CI, 1.09 to 1.57) for first MI. Parents who lost a child unexpectedly, especially from sudden infant death syndrome, experienced higher RRs.Conclusions-The death of a child was associated with an increased risk of MI in bereaved parents.