title: Sudden death and myocardial infarction in first degree relatives as predictors of primary cardiac arrest.
abstract: The hypothesis that family history (FH) of myocardial infarction (MI) and FH of sudden death (SD) are both independent risk factors for primary cardiac arrest (PCA) was examined in a case-control study. PCA cases were attended by paramedics (1988-1994) and community-based age and sex matched controls were identified. Subjects (25-74 years) were free of prior clinically-recognized heart disease and major co-morbidity. Interviewers obtained a detailed history of MI and SD in first-degree relatives from spouses of 235 cases and 374 control subjects. A parental history of early-onset SD (age <65) was associated with an increased risk of PCA (odds ratio (OR)=2.69, 95% CI=1.35-5.36), after adjustment for parental history of MI and other risk factors. A parental history of late-onset SD was not associated with PCA risk (OR=0.94, 95% CI=0.55-1.62). Additionally, parental history of SD was related to early-onset PCA (OR=1.89, 95% CI=1.08-3.30) but not to late-onset PCA (OR=0.89, 95% CI=0.49-1.61). In contrast, parental MI (early/late) was related to PCA (early/late), after adjustment for other risk factors and parental history of SD. Similar results were observed in first-degree relatives. Findings suggest a potential role of familial factors related to both MI and SD in PCA. Stronger findings for a familial patterning of PCA were noted for early onset disease in cases and their relatives.
authors.affiliation: Department of Social Medicine, The Hebrew University-Hadassah School of Public Health, PO Box 12272, Jerusalem 91120, Israel. yfried@vms.huji.ac.il
authors.forename: Yechiel
authors.initials: Y
authors.lastname: Friedlander
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Patrick
authors.initials: P
authors.lastname: Arbogast
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Sheila
authors.initials: S
authors.lastname: Weinmann
authors.forename: Rozenn N
authors.initials: RN
authors.lastname: Lemaitre
authors.forename: T E
authors.initials: TE
authors.lastname: Raghunathan
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Cobb
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D005192:Family Health; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000235:genetics*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014861:Washington / Q000453:epidemiology