Familial Mortality Risks in Patients With Ischemic Stroke: A Swedish Sibling Study

Area of Science:

• Neurology
• Genetics
• Public Health

Background:

• Familial factors influencing ischemic stroke (IS) prognosis remain largely unknown.
• This study investigates familial mortality risks associated with IS in Swedish sibling pairs.

Purpose of the Study:

• To evaluate the association between sibling survival after IS and overall mortality risk.
• To identify specific demographic groups, such as younger individuals and males, who may be at higher risk.

Main Methods:

• Utilized Swedish nationwide registers to identify 1380 sibling pairs (2760 cases) hospitalized for first-time IS (1991-2010).
• Employed Cox regression to determine familial hazard ratios (FHRs) for mortality, adjusting for various clinical and demographic factors.
• Categorized sibling survival as short (<1-5 years) or long (≥1-5 years) post-IS hospitalization.

Main Results:

• Short sibling survival (<3 or <4 years) was linked to increased overall mortality after IS (adjusted FHR 1.29 and 1.24, respectively).
• This association was more pronounced in younger individuals (<62 years) and males, with the highest FHR observed in young males (1.80).
• Mortality risk was also associated with sex, education, age at onset, year of diagnosis, hospitalization duration, and comorbidities like heart disease and diabetes.

Conclusions:

• A family history of short survival after IS is associated with increased mortality, especially in younger male patients.
• Further research is warranted to elucidate the underlying genetic and non-genetic familial environmental factors contributing to this observed association.