Association between family history and coronary heart disease death across long-term follow-up in men: the Cooper Center Longitudinal Study.
Association between family history and coronary heart disease death across long-term follow-up in men: the Cooper Center Longitudinal Study.
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DOI：
10.1161/circulationaha.111.065490
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发表时间：
2012-06-26
期刊：
影响因子：
37.8
通讯作者：
Berry JD
中科院分区：
文献类型：
--
作者：
Bachmann JM;Willis BL;Ayers CR;Khera A;Berry JD
冠心病家族史作为冠心病事件的一个独立危险因素已被广泛研究。然而，在长期随访中，关于家族史与冠心病风险之间关系的数据很少。我们纳入了来自库珀中心纵向研究的49255名男性。早发冠心病家族史定义为：50岁以下亲属有心绞痛、心肌梗死、血管成形术或搭桥手术史。死因特异性死亡率来自国家死亡指数。在3个独特的随访期（0-10年，>10-20年和>20年）中比较了过早家族史与心血管疾病（CVD）或CHD死亡之间的关联。使用改良的生存分析技术，以非CVD死亡作为竞争事件，调整竞争风险，估计终生风险。在811708人年的随访后，有919例CHD死亡和1456例CVD死亡。校正传统危险因素后，早发家族史与>10 - 20年冠心病死亡率相关（1.59; 95%置信区间，1.14-2.22）和>20年（1.43; 95%置信区间，1.05-1.95），0 - 10年的置信区间更宽（1.32; 95%置信区间，0.76-2.31）。CVD死亡率也观察到类似的结果。与无冠状动脉疾病家族史的男性相比，过早家族史与CHD和CVD死亡率的终生风险高出约50%相关（分别为13.7%对8.9%和21%对14.1%）。在长期随访中，过早的家族史与CHD和CVD死亡风险的持续增加相关，导致终生风险估计值显著升高。
Family history of coronary heart disease (CHD) has been well studied as an independent risk factor for CHD events in the short term (<10 years). However, data are sparse on the association between family history and risk for CHD across long-term follow-up. We included 49 255 men from the Cooper Center Longitudinal Study. Premature family history of CHD was defined as the presence of angina, myocardial infarction, angioplasty, or bypass surgery in a relative <50 years of age. Cause-specific mortality was obtained from the National Death Index. The association between premature family history and cardiovascular disease (CVD) or CHD death was compared across 3 unique follow-up periods (0–10, >10–20, and >20 years). Lifetime risk was estimated by use of a modified survival analytic technique adjusted for competing risk with non-CVD death as the competing event. After 811 708 person-years of follow-up, there were 919 CHD deaths and 1456 CVD deaths. After adjustment for traditional risk factors, premature family history was associated with CHD mortality >10 to 20 years (1.59; 95% confidence interval, 1.14–2.22) and >20 years (1.43; 95% confidence interval, 1.05–1.95) with wider confidence intervals at 0 to 10 years (1.32; 95% confidence interval, 0.76–2.31). Similar findings were observed for CVD mortality. Compared with men without a family history of coronary artery disease, premature family history was associated with an ≈50% higher lifetime risk for both CHD and CVD mortality (13.7% versus 8.9% and 21% versus 14.1%, respectively). Premature family history was associated with a persistent increase in both CHD and CVD mortality risk across long-term follow-up, resulting in significantly higher lifetime risk estimates.