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Family History is Related to High Risk of Recurrent Events after Ischemic Stroke or Transient Ischemic Attack

  • Xing Zhang
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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  • Si Cheng
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author
  • Hongqiu Gu
    Affiliations
    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author
  • Yingyu Jiang
    Affiliations
    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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  • Hao Li
    Affiliations
    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author
  • Zixiao Li
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author
  • Xia Meng
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author
  • Yongjun Wang
    Correspondence
    Corresponding author at: Beijing Tiantan Hospital, Department of Neurology, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, Beijing, China

    Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
    Search for articles by this author

      Abstract

      Objective

      Prior data suggest paternal or sibling stroke was associated with increased risk of offspring stroke. Whether family history of cardiovascular disease (FHc) predicts risk of stroke recurrence remains unclear, we aim to determine this issue on patients with ischemic stroke (IS) or transient ischemic attack (TIA).

      Materials and Methods

      This is a post hoc analysis based on the Third China National Stroke Registry III. IS/TIA patients with data of FHc status were included. FHc was defined as family history of coronary heart disease (CHD) or stroke among first-degree relatives (include parents, children, and siblings (same parents)). Cox proportional hazards regression models were performed to assess the association between FHc and recurrent events at 1 year follow-up.

      Results

      Totally 14,208 patients with verified FHc status were included, 4,454 (31.3%) were female and the median (IQR) age was 62.0 (54.0, 70.0) years. Of these, 294 (2.1%), 726 (5.1%) and 1936 (13.6%) had family history of both CHD and stroke, family history of CHD, and family history of stroke only, respectively. Using multivariable Cox models adjusted for age, sex, and vascular risk factors, we found that patients with FHc experienced higher risk of stroke recurrence (HR=1.151, 95%CI=1.000-1.324) and combined vascular events (HR=1.186, 95%CI=1.036-1.358) at 1 year compared with those without FHc. In sensitivity analysis on patients who received primary secondary prevention treatment of antiplatelet and statins, the association persisted.

      Conclusions

      FHc is associated with increased risk of stroke recurrence even under primary secondary prevention treatment.

      Key Words

      Abbreviation:

      CNSR III (the Third China National Stroke Registry), FHc (family history of cardiovascular disease), TIA (transient ischemic attack), IS (ischemic stroke), BMI (body mass index), CHD (coronary heart disease), LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cholesterol), TG (triglycerides), SBP (systolic blood pressure), FPG (fasting plasma glucose)
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