Family history, comorbidity and risk of thoracic aortic disease: a population-based case-control study.

Source

Cardiovascular Surgery Unit, Karolinska Institutet, , Stockholm, Sweden.

Abstract

OBJECTIVE:

To examine the risk of thoracic aortic disease (TAD) when one or more first-degree relatives are affected, and to relate the risk of family history to the risk of other cardiopulmonary comorbidity.

DESIGN:

Population-based, matched, case-control study.

SETTING:

Registry-based investigation.

PATIENTS:

All cases, nationwide, of TAD diagnosed 2001-2005 in individuals born 1932 or later (n=2436) were identified, and a random control-group (n=12 152) matched for age, sex and geography was generated. First-degree relatives were identified in the Multigeneration Registry. Family history of TAD was assessed by cross-linking nationwide health registries.

INTERVENTIONS:

None.

RESULTS:

Family history was present in 108 cases (4.4%), compared with 93 (0.77%) controls (p<0 .0001="" 12="" 179="" 20="" 4.3="" 5.5="" 5.8="" 6.3="" 7.2="" 7.7="" 9.8="" affected="" age="" among="" and="" cardiopulmonary="" ci="" comorbidities="" conferred="" failure="" group="" heart="" highest="" in="" increased="" men="" more="" number="" of="" one="" or="" p="" pronounced="" relative="" relatives.="" relatives:="" risk="" slightly="" tad="" than="" the="" to="" two="" versus="" vs="" was="" with="" women="" years="" youngest="">

CONCLUSIONS:

Family history confers a significantly increased (sixfold to 20-fold) relative risk of TAD. The effect is more pronounced in women and in younger subjects, and is not conveyed by cardiopulmonary comorbidity. Knowledge of family history is important to counselling, treatment indications, surveillance and screening protocols.