Family History as a Risk Factor for Carotid Artery Stenosis
Family History as a Risk Factor for Carotid Artery Stenosis
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DOI：
10.1161/strokeaha.114.006245
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发表时间：
2014-08-01
期刊：
影响因子：
8.3
通讯作者：
Kullo, Iftikhar J.
中科院分区：
文献类型：
--
作者：
Khaleghi, Mahyar;Isseh, Iyad N.;Kullo, Iftikhar J.
背景和目的：我们调查了中风或冠心病(CHD)家族史是否与颈动脉狭窄(CAS)相关。方法：研究队列包括864名CAS患者(72+/-8岁；68%男性)和1698名对照组(61+/-11岁；55%男性)。超声或颈动脉血运重建史将颈动脉狭窄定义为<gt；=70%狭窄。对照组无CAS、脑血管疾病或冠心病病史。卒中和冠心病家族史定义为有1个一级亲属在65岁之前有卒中或冠心病。结果：与对照组相比，CAS患者卒中或冠心病家族史的发生率更高，其优势比(95%可信区间)分别为2.02(1.61~2.53)和2.01(1.70~2.37)。在调整了年龄、性别、体重指数、吸烟、糖尿病、高血压和血脂异常后，相关性仍然显著；优势比分别为1.41(1.06-1.90)和1.69(1.35-2.10)。患中风或冠心病的亲属数目越多，发生CAS的几率越高；调整后的优势比分别为1.25(0.91-1.72)和1.46(1.14-1.89)，而1个和>；=2个患中风和冠心病的患病亲属分别为2.65(1.35-5.40)和2.13(1.57-2.90)。结论-中风和冠心病家族史均与CAS相关，提示共同的遗传和环境因素参与了CAS的风险。
Background and Purpose-We investigated whether family history of stroke or coronary heart disease (CHD) is associated with presence of carotid artery stenosis (CAS).Methods-The study cohort included 864 patients (72 +/- 8 years; 68% men) with CAS and 1698 controls (61 +/- 11 years; 55% men) referred for noninvasive vascular testing. CAS was defined as >= 70% stenosis in the internal carotid artery on ultrasound or history of carotid revascularization. Controls did not have CAS or history of cerebrovascular disease or CHD. Family history of stroke and CHD was defined as having >= 1 first-degree relative who had stroke or CHD before age 65 years. Logistic regression analysis was used to evaluate whether family history of stroke or CHD was associated with presence of CAS, independent of conventional risk factors.Results-Family history of stroke and CHD was present more often in patients with CAS than in controls, with a resulting odds ratios (95% confidence interval) of 2.02 (1.61-2.53) and 2.01 (1.70-2.37), respectively. The associations remained significant after adjustment for age, sex, body mass index, smoking, diabetes mellitus, hypertension, and dyslipidemia; odds ratios: 1.41 (1.06-1.90) and 1.69 (1.35-2.10), respectively. A greater number of affected relatives with stroke or CHD was associated with higher odds of CAS; adjusted odds ratios: 1.25 (0.91-1.72) and 1.46 (1.14-1.89) versus 2.65 (1.35-5.40) and 2.13 (1.57-2.90) for patients with 1 and >= 2 affected relatives with stroke and CHD, respectively.Conclusions-Family history of stroke, and of CHD were each associated with CAS, suggesting that shared genetic and environmental factors contribute to the risk of CAS.