Open AccessFamilial Mortality Risks in Patients With Heart Failure—A Swedish Sibling Study
Author(s) -
Lindgren Magnus P.,
Smith J. Gustav,
Li Xinjun,
Sundquist Jan,
Sundquist Kristina,
Zöller Bengt
Publication year - 2018
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.010181
Subject(s) - medicine , hazard ratio , proband , confidence interval , sibling , proportional hazards model , heart failure , population , survival analysis , risk factor , pediatrics , psychology , developmental psychology , biochemistry , chemistry , environmental health , mutation , gene
Background The influence of familial factors on the prognosis of heart failure ( HF ) is unknown. This nationwide follow‐up study aimed to determine familial mortality risks of HF among Swedish siblings hospitalized for HF . Methods and Results We linked several Swedish nationwide registers for individuals aged 0 to 80 years. The study population consisted of 373 people hospitalized for HF for the first time between 2000 and 2012 with 1 proband sibling previously hospitalized for HF for the first time between 2000 and 2007. Families with congenital heart disease were excluded. Familial hazard ratios ( HR s) for mortality after first HF hospitalization were determined with Cox regression. The influence of proband survival was categorized as short survival (<5 years) or long survival (≥5 years) and determined continuously for the initial 5 years of proband survival. Adjustments were made for age, sex, time period, and common HF comorbidities. Short proband survival was associated with a HR of 2.02 (95% confidence interval, 1.32–3.09) for overall mortality. This HR was 2.35 (95% confidence interval, 1.18–4.67) in patients without preceding coronary heart disease, whereas patients with ischemic HF had an HR of 1.84 (95% confidence interval, 1.05–3.23). For each year of proband survival, the risk of death decreased, with a HR of 0.86 (95% confidence interval, 0.77–0.98). Conclusions Our results suggest that family history of poor survival in specific relation to HF is an important risk factor for death in HF patients. Additional studies are needed to characterize the molecular underpinnings and detailed phenotypic characteristics of such patients.