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Family history and socioeconomic factors as predictors of myocardial infarction, unstable angina and stroke in an Italian population

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Abstract

A comprehensive case-control study was conducted in an Italian region in order to compare the influence of family history of cardiovascular events, socioeconomic factors, social networks, and their joint associations with major risk factors, on the risk, of myocardial infarction (MI), unstable angina (UA) and ischemic stroke (IS). A total of 513 patients with MI, 178 with UA, 237 with IS, and 928 hospitalised controls were recruited. The odds ratio (OR) of MI for two or more relatives with a positive history of MI was 3.6 (95% CI: 1.8–7.3). Family history of MI was predictive for UA (OR = 5.8; 95% CI: 1.2–28.7), but not for IS. A family history of stroke was more associated with the risk of MI than of IS. After adjustment for known risk factors, the OR of MI for more educated people was 2.1 (1.3–3.6) compared with less-educated people. Large family size seemed to be protective for MI. The effect of major risk factors on MI ranged from additive (diabetes) to multiplicative jointly with high education and family history of MI. A family history of stroke increased IS risk threefold jointly with smoking and hyperlipidemia, and eightfold with diabetes. Besides a family history of MI and IS, in this community a higher educational status seems to better identify groups at increased risk of MI. The joint associations have important preventive implications since by identifying high-risk individuals (for MI and IS) a more careful assessment and control of risk factors amenable to intervention may be performed.

Participating clinical centres: Atessa: L. Massa, M. Puglfese (Medicina); Avezzano: G. Rabftti, G. Del Bove Orlandi (Medicina); E. Laconi F. Tiburzi (UTIC); Casoli: M. Padula (Medicina); Castel di Sangro: P Caracciolo, V Di Tomasso (Medicina); Chieti: S. Sensi, G. Bitti (Medicina); D. Gambi, S. Viola (Neurologia); A. Rossi, C. Ciglia (UTIC); Gissi: M. Colaneri (Medicina); Giulianova: N. Di Giacinto (UTIC); Guardiagrele: F. Liberatoscioli, M. De Luca (UTIC); Lanciano: V Montagano, B. Di Martino (Neurologia); A. Ottaviano, G. Mastrogiuseppe (UTIC); L'Aquila: E. Marsili, P. Marsili (UTIC); Ortona: G. Giambuzzi (Medicina); Penne: O. Pesa (Medicina); D. Di Gregorio, G. Di Paolo (UTIC); Pescara: B. Carosella, A. Mancini (Medicina); G. Liberti, G. Acerbi (Neurochirurgia); E. D'Annunzio, C. Stoduto (UTIC); Pescina: A. Biocca, G. Barbati (Medicina); Popoli: D. Artese, M. Di Cioccio (Medicina); A. Mobili (UTIC); S. Omero: G. Triozzi, E. Di Biase (Medicina); Sulmona: E. Conti, G. Bonasia (UTIC); Tagliacozzo: G. Appodia (Medicina); Teramo: L. Piccioni (UTIC); Tocco Casauria: M. Zappacosta (Medicina); Vasto: Del Fomo (Medicina); D-Antonini, M. Cipulli (Neurologia); G. Di Marco, E. Bottari (UTIC). UTIC: Unità di Terapia Intensiva Coronarica.

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Authors and Affiliations

  1. Laboratory of Clinical Pharmacology and Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Via Nazionale, 1-66030, Santa Maria Imbaro (Chieti), Italy

    Felice Vitullo

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  1. Felice Vitullo
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  2. Roberto Marchioli
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  3. Rocco Di Mascio
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  4. Luciano Cavasinni
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  5. Alberta Di Pasquale
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  6. Gianni Tognoni
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PROGETTO 3A Investigators

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PROGETTO 3A (Alimentazione - Aterosclerosi - Abruzzo). Scientific advisory board: F. Capani, F. D'Agostino G. de Gaetano & F. Stante

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Vitullo, F., Marchioli, R., Di Mascio, R. et al. Family history and socioeconomic factors as predictors of myocardial infarction, unstable angina and stroke in an Italian population. Eur J Epidemiol 12, 177–185 (1996). https://doi.org/10.1007/BF00145504

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