Sibling history is associated with heart failure after a first myocardial infarction

Abstract

ObjectiveMorbidity and mortality due to heart failure (HF) as a complication of myocardial infarction (MI) is high, and remains among the leading causes of death and hospitalisation. This study investigated the association between family history of MI with or without HF, and the risk of developing HF after first MI.MethodsThrough nationwide registries, we identified all individuals aged 18–50 years hospitalised with first MI from 1997 to 2016 in Denmark. We identified 13 810 patients with MI, and the cohort was followed until HF diagnosis, second MI, 3 years after index MI, emigration, death or the end of 2016, whichever occurred first. HRs were estimated by Cox hazard regression models adjusted for sex, age, calendar year and comorbidities (reference: patients with no family history of MI).ResultsAfter adjustment, we observed an increased risk of MI-induced HF for those having a sibling with MI with HF (HR 2.05, 95% CI 1.02 to 4.12). Those having a sibling with MI without HF also had a significant, but lower increased risk of HF (HR 1.39, 95% CI 1.05 to 1.84). Parental history of MI with or without HF was not associated with HF.ConclusionIn this nationwide cohort, sibling history of MI with or without HF was associated with increased risk of HF after first MI, while a parental family history was not, suggesting that shared environmental factors may predominate in the determination of risk for developing HF.

Cardiovascular Family History Increases the Risk of Disease Recurrence After a First Myocardial Infarction

“…These findings may also suggest that shared environmental exposure between siblings could influence rASCVD heritability to a greater extent than the parental exposure. 30 , 31 , 32 HRs for a sibling history of stroke were not as heavily attenuated after adjustment of metabolic risk factors as with a family history of CHD, of which the association was largely attenuated after risk factor adjustment. The observed association between a family history of CHD and rASCVD could largely be attributed to parental family history, perhaps partly represented by residuals of age.…”