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Circulation. 1998;97:155-160

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(Circulation. 1998;97:155-160.)
© 1998 American Heart Association, Inc.


Clinical Investigation and Reports

Family History as a Risk Factor for Primary Cardiac Arrest

Yechiel Friedlander, PhD; David S. Siscovick, MD, MPH; Sheila Weinmann, PhD; Melissa A. Austin, PhD; Bruce M. Psaty, MD, PhD; Rozenn N. Lemaitre, PhD, MPH; Patrick Arbogast, MS; T. E. Raghunathan, PhD; ; Leonard A. Cobb, MD

From the Cardiovascular Health Research Unit, Departments of Medicine (D.S.S., S.W., B.M.P., R.N.L., L.A.C.), Epidemiology (D.S.S., M.A.A., B.M.P.), and Biostatistics (P.A.), University of Washington, Seattle; the Institute for Social Research, University of Michigan, Ann Arbor (T.E.R.); and the Department of Social Medicine, The Hebrew University–Hadassah School of Public Health, Jerusalem, Israel (Y.F.).

Correspondence to Dr Y. Friedlander, Department of Social Medicine, The Hebrew University–Hadassah School of Public Health, POB 12272, Jerusalem 91120, Israel. E-mail yfried{at}vms.huji.ac.il

Background—The hypothesis that a family history of myocardial infarction (MI) or primary cardiac arrest (PCA) is an independent risk factor for primary cardiac arrest was examined in a population-based case-control study. In addition, we investigated whether recognized risk factors account for the familial aggregation of these cardiovascular events.

Methods and Results—PCA cases, 25 to 74 years old, attended by paramedics during the period 1988 to 1994 and population-based control subjects matched for age and sex were identified from the community by random digit dialing. All subjects were free of recognized clinical heart disease and major comorbidity. A detailed history of MI and PCA in first-degree relatives was collected in interviews with the spouses of case and control subjects by trained interviewers using a standardized questionnaire. For each familial relationship, there was a higher rate of MI or primary cardiac arrest (MI/PCA) in relatives of case compared with relatives of control subjects. Overall, the rate of MI/PCA among first-degree relatives of cardiac arrest patients was almost 50% higher than that in first-degree relatives of control subjects (rate ratio [RR]=1.46; 95% CI=1.23 to 1.72). In a multivariate logistic model, family history of MI/PCA was associated with PCA (RR=1.57; 95% CI=1.27 to 1.95) even after adjustment for other common risk factors.

Conclusions—Family history of MI or PCA is positively associated with the risk of primary cardiac arrest. This association is mostly independent of familial aggregation of other common risk factors.


Key Words: risk factors • heart arrest • myocardial infarction




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