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Chung JW, Kim BJ, Han MK, Kang K, Park JM, Park SS, Park TH, Cho YJ, Hong KS, Lee KB, Kim JG, Ko Y, Lee S, Nah HW, Kim DH, Cha JK, Oh MS, Yu KH, Lee BC, Jang MS, Lee JS, Lee J, Bae HJ. Family History and Risk of Recurrent Stroke. Stroke 2016; 47:1990-6. [DOI: 10.1161/strokeaha.116.013148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/13/2016] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Jong-Won Chung
- 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,
| | - Beom Joon Kim
- 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,
| | - Moon-Ku Han
- 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,
| | - Kyusik Kang
- 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,
| | - Jong-Moo Park
- 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,
| | - Sang-Soon Park
- 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,
| | - Tai Hwan Park
- 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,
| | - Yong-Jin Cho
- 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,
| | - Keun-Sik Hong
- 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,
| | - Kyung Bok Lee
- 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,
| | - Jae Guk Kim
- 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,
| | - Youngchai Ko
- 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,
| | - SooJoo Lee
- 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,
| | - Hyun-Wook Nah
- 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,
| | - Dae-Hyun Kim
- 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,
| | - Jae-Kwan Cha
- 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,
| | - Mi-Sun Oh
- 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,
| | - Kyung-Ho Yu
- 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,
| | - Byung-Chul Lee
- 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,
| | - Myung Suk Jang
- 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,
| | - Ji Sung Lee
- 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,
| | - Juneyoung Lee
- 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,
| | - Hee-Joon Bae
- 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,
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Affiliation(s)
- Jonathon P Fanning
- From the School of Medicine (J.P.F., A.J.W., A.A.W., J.F.F.) and Critical Care Research Group (CCRG), The Prince Charles Hospital (J.P.F., J.F.F.), The University of Queensland, Brisbane, Queensland, Australia; Department of Medical Imaging (A.J.W.) and Adult Intensive Care Services (J.F.F.), The Prince Charles Hospital, Brisbane, Queensland, Australia; Department of Medical Imaging, Monash Medical Centre, Melbourne, Victoria, Australia (A.J.W.); and Department of Neurology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (A.A.W.).
| | - Allan J Wesley
- From the School of Medicine (J.P.F., A.J.W., A.A.W., J.F.F.) and Critical Care Research Group (CCRG), The Prince Charles Hospital (J.P.F., J.F.F.), The University of Queensland, Brisbane, Queensland, Australia; Department of Medical Imaging (A.J.W.) and Adult Intensive Care Services (J.F.F.), The Prince Charles Hospital, Brisbane, Queensland, Australia; Department of Medical Imaging, Monash Medical Centre, Melbourne, Victoria, Australia (A.J.W.); and Department of Neurology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (A.A.W.)
| | - Andrew A Wong
- From the School of Medicine (J.P.F., A.J.W., A.A.W., J.F.F.) and Critical Care Research Group (CCRG), The Prince Charles Hospital (J.P.F., J.F.F.), The University of Queensland, Brisbane, Queensland, Australia; Department of Medical Imaging (A.J.W.) and Adult Intensive Care Services (J.F.F.), The Prince Charles Hospital, Brisbane, Queensland, Australia; Department of Medical Imaging, Monash Medical Centre, Melbourne, Victoria, Australia (A.J.W.); and Department of Neurology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (A.A.W.)
| | - John F Fraser
- From the School of Medicine (J.P.F., A.J.W., A.A.W., J.F.F.) and Critical Care Research Group (CCRG), The Prince Charles Hospital (J.P.F., J.F.F.), The University of Queensland, Brisbane, Queensland, Australia; Department of Medical Imaging (A.J.W.) and Adult Intensive Care Services (J.F.F.), The Prince Charles Hospital, Brisbane, Queensland, Australia; Department of Medical Imaging, Monash Medical Centre, Melbourne, Victoria, Australia (A.J.W.); and Department of Neurology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (A.A.W.)
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