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Stroke. 2016 Aug;47(8):1990-6. doi: 10.1161/STROKEAHA.116.013148. Epub 2016 Jul 12.

Family History and Risk of Recurrent Stroke.

Author information

1
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, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Soonchunhyang University Hospital, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Eulji University Hospital, Eulji University, Daejeon, Republic of Korea (J.G.K., Y.K., S.J.L.); Department of Neurology, Dong-A University Hospital, Pusan, Republic of Korea (H.-W.N., D.-H.K., J-K.C.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea (M.-S.O., K.-H.Y., B.-C.L.); Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); and Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.).
2
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, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea (Y.-J.C., K.-S.H.); Department of Neurology, Soonchunhyang University Hospital, Seoul, Republic of Korea (K.B.L.); Department of Neurology, Eulji University Hospital, Eulji University, Daejeon, Republic of Korea (J.G.K., Y.K., S.J.L.); Department of Neurology, Dong-A University Hospital, Pusan, Republic of Korea (H.-W.N., D.-H.K., J-K.C.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea (M.-S.O., K.-H.Y., B.-C.L.); Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea (J.S.L.); and Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (J.L.). jyleeuf@korea.ac.kr braindoc@snu.ac.kr.

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.

KEYWORDS:

ischemia; prognosis; proportional hazard models; risk assessment; stroke

PMID:
27406105
DOI:
10.1161/STROKEAHA.116.013148
[Indexed for MEDLINE]

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