title: Mortality From myocardial infarction after the death of a sibling: a nationwide follow-up study from Sweden.
abstract: BACKGROUND
  Death of a sibling represents a stressful life event and could be a potential trigger of myocardial infarction (MI). We studied the association between loss of an adult sibling and mortality from MI up to 18 years after bereavement.
  
  
  RESULTS
  We conducted a follow-up study for Swedes aged 40 to 69 years between 1981 and 2002, based on register data covering the total population (N=1 617 010). Sibling deaths could be observed from 1981 and on. An increased mortality rate from MI was found among women (1.25 CI 1.02 to 1.54) and men (1.15 CI 1.03 to 1.28) who had experienced death of an adult sibling. An elevated rate some years after bereavement was found among both women (during the fourth to sixth half-years after the death) and men (during the second to sixth half-years after the death), whereas limited support for a short-term elevation in the rate was found (during the first few months since bereavement). External causes of sibling death were associated with increased MI mortality among women (1.54 CI 1.07 to 2.22), whereas nonexternal causes showed associations in men (1.23 CI 1.09 to 1.38). However, further analyses showed that if the sibling also died from MI, associations were primarily found among both women (1.62 CI 1.00 to 2.61) and men (1.98 CI 1.59 to 2.48).
  
  
  CONCLUSIONS
  Our study provided the first large-scale evidence for mortality from MI associated with the death of a sibling at an adult age. The fact that findings suggested associations primarily between concordant causes of death (both died of MI) could indicate genetic resemblance or shared risk factors during childhood. Future studies on bereavement should carefully deal with the possibility of residual confounding.
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden. mikael.rostila@chess.su.se
authors.forename: Mikael
authors.initials: M
authors.lastname: Rostila
authors.forename: Jan
authors.initials: J
authors.lastname: Saarela
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000328:Adult; D000368:Aged; D001601:Bereavement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology; D017678:Sex Distribution; D035781:Siblings; D013548:Sweden / Q000453:epidemiology
references.citation: Brain Behav Immun. 2012 Oct;26(7):1066-71
references.pmid: 22735772
references.citation: Cleve Clin J Med. 2007 Feb;74 Suppl 1:S17-22
references.pmid: 17455537
references.citation: Am J Epidemiol. 2012 Aug 15;176(4):338-46
references.pmid: 22814369
references.citation: Br Med J. 1969 Mar 22;1(5646):740-3
references.pmid: 5769860
references.citation: Neth Heart J. 2007;15(9):283-5
references.pmid: 18074000
references.citation: Demography. 2012 May;49(2):575-606
references.pmid: 22427278
references.citation: Heart Lung Circ. 2011 Feb;20(2):91-8
references.pmid: 21147029
references.citation: Cardiovasc Revasc Med. 2007 Oct-Dec;8(4):289-92
references.pmid: 18053952
references.citation: Soc Sci Med. 1987;24(2):117-24
references.pmid: 3551087
references.citation: N Engl J Med. 1998 Jan 15;338(3):171-9
references.pmid: 9428819
references.citation: N Engl J Med. 1994 Apr 14;330(15):1041-6
references.pmid: 8127331
references.citation: Am J Public Health. 1996 Aug;86(8):1087-93
references.pmid: 8712266
references.citation: Death Stud. 1997 Sep-Oct;21(5):477-99
references.pmid: 10175164
references.citation: J Epidemiol Community Health. 2012 Oct;66(10):927-33
references.pmid: 22045850
references.citation: Circ Cardiovasc Genet. 2009 Feb;2(1):7-15
references.pmid: 20031562
references.citation: J Am Coll Cardiol. 2008 Apr 1;51(13):1237-46
references.pmid: 18371552
references.citation: Neuroimage. 2009 Sep;47(3):891-6
references.pmid: 19481155
references.citation: Lancet. 2003 Feb 1;361(9355):363-7
references.pmid: 12573371
references.citation: J Pain Symptom Manage. 2008 Jan;35(1):58-69
references.pmid: 17949942
references.citation: Int J Clin Pract. 2012 Jul;66(7):631-9
references.pmid: 22698415
references.citation: Psychosom Med. 1999 Jul-Aug;61(4):476-87
references.pmid: 10443756
references.citation: Circulation. 2012 Jan 24;125(3):491-6
references.pmid: 22230481
references.citation: BMJ. 2004 Jul 24;329(7459):184-5
references.pmid: 15271805
references.citation: Hypertension. 2001 Feb;37(2 Pt 2):350-6
references.pmid: 11230299
references.citation: J Psychosom Res. 1987;31(3):325-33
references.pmid: 3625585
references.citation: Psychosom Med. 1980 Nov;42(6):567-74
references.pmid: 7465742
references.citation: Intern Med J. 2009 Jun;39(6):370-8
references.pmid: 19460057
references.citation: Suicide Life Threat Behav. 1991 Winter;21(4):385-401
references.pmid: 1799019
references.citation: Int J Cardiol. 2009 Jul 10;135(3):370-5
references.pmid: 18599137
references.citation: J Youth Adolesc. 1983 Apr;12(2):137-61
references.pmid: 24306228