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Gustav Smith

Associate professor

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Risk of Stroke in Patients With Atrial Fibrillation Is Associated With Stroke in Siblings : A Nationwide Study

Author

  • John Berntsson
  • Xinjun Li
  • Bengt Zöller
  • Andreas Martinsson
  • Pontus Andell
  • Steven A. Lubitz
  • Gunnar Engström
  • Kristina Sundquist
  • J. Gustav Smith

Summary, in English

Background: It remains unclear whether heritable factors can contribute to risk stratification for ischemic stroke in patients with atrial fibrillation (AF). We examined whether having a sibling with ischemic stroke was associated with increased risk of ischemic stroke and mortality in patients with AF. Methods and Results: In this nationwide study of the Swedish population, patients with AF and their siblings were identified from the Swedish patient registers and the Swedish MGR (Multi-Generation Register). Ischemic stroke events were retrieved from the Swedish patient registers and CDR (Cause of Death Register). Risk of ischemic stroke was compared between patients with AF with and without a sibling affected by ischemic stroke, AF, or both ischemic stroke and AF. The total study population comprised 113 988 subjects (mean age, 60±12 years) diagnosed with AF between 1989 and 2012. In total, 11 709 of them were diagnosed with a first ischemic stroke and 20 097 died during a mean follow-up time of 5.5 years for ischemic stroke and 5.9 years for mortality. After adjustment for covariates having a sibling with ischemic stroke, or both ischemic stroke and AF, was associated with increased risk of ischemic stroke (hazard ratio, 1.31; 95% CI, 1.23-1.40 or hazard ratio, 1.36; 95% CI, 1.24-1.49, respectively). Furthermore, ischemic stroke in a sibling was associated with all-cause mortality (hazard ratio, 1.09; 95% CI, 1.05-1.14). In contrast, the risk of stroke was only marginally increased for patients with AF with a spouse affected by ischemic stroke. Conclusions: Having a sibling affected by ischemic stroke confers an increased risk of ischemic stroke and death independently of traditional risk factors in patients with AF.

Department/s

  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Molecular Epidemiology and Cardiology
  • Cardiovascular Research - Epidemiology
  • Family Medicine and Clinical Epidemiology
  • Family medicine, cardiovascular medicine and genetics
  • EpiHealth: Epidemiology for Health
  • Cardiology
  • WCMM-Wallenberg Centre for Molecular Medicine
  • Cardiovascular Epigenetics

Publishing year

2020-02-04

Language

English

Pages

014132-014132

Publication/Series

Journal of the American Heart Association

Volume

9

Issue

3

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • atrial fibrillation
  • family history
  • genetics
  • risk factors
  • stroke

Status

Published

Research group

  • Molecular Epidemiology and Cardiology
  • Cardiovascular Research - Epidemiology
  • Family Medicine and Clinical Epidemiology
  • Family medicine, cardiovascular medicine and genetics
  • Cardiovascular Epigenetics

ISBN/ISSN/Other

  • ISSN: 2047-9980