Dataset Information

Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study.

ABSTRACT: OBJECTIVE:There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. METHODS:Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a random-effects meta-analysis, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD, after adjustment for age, study centre and several socioeconomic and biological risk factors. RESULTS:Compared with nulliparous women, the adjusted HR was 1.19 (95% CI: 1.01-1.41) among parous women; HRs were higher among women with more children (e.g., adjusted HR: 1.95 (95% CI: 1.19-3.20) for women with five or more children). Compared with women who did not breastfeed, the adjusted HR was 0.71 (95% CI: 0.52-0.98) among women who breastfed. For childbearing women who never breastfed, the adjusted HR was 1.58 (95% CI: 1.09-2.30) compared with nulliparous women, whereas for childbearing women who breastfed, the adjusted HR was 1.19 (95% CI: 0.99-1.43). CONCLUSION:Having more children was associated with a higher risk of CHD later in life, whereas breastfeeding was associated with a lower CHD risk. Women who both had children and breastfed did have a non-significantly higher risk of CHD.

SUBMITTER: Peters SA

PROVIDER: S-EPMC6217919 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study.

Peters Sanne Ae SA van der Schouw Yvonne T YT Wood Angela M AM Sweeting Michael J MJ Moons Karel Gm KG Weiderpass Elisabete E Arriola Larraitz L Benetou Vassiliki V Boeing Heiner H Bonnet Fabrice F Butt Salma T ST Clavel-Chapelon Françoise F Drake Isabel I Gavrila Diana D Key Timothy J TJ Klinaki Eleni E Krogh Vittorio V Kühn Tilman T Lassale Camille C Masala Giovanna G Matullo Giuseppe G Merritt Melissa M Molina-Portillo Elena E Moreno-Iribas Conchi C Nøst Therese H TH Olsen Anja A Onland-Moret N Charlotte NC Overvad Kim K Panico Salvatore S Redondo M Luisa ML Tjønneland Anne A Trichopoulou Antonia A Tumino Rosario R Turzanski-Fortner Renée R Tzoulaki Ioanna I Wennberg Patrik P Winkvist Anna A Thompson Simon G SG Di Angelantonio Emanuele E Riboli Elio E Wareham Nicholas J NJ Danesh John J Butterworth Adam S AS

European journal of preventive cardiology 20160704 16

<h4>Objective</h4>There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study.<h4>Methods</h4>Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC ...[more]

PMID: 27378766

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Project description:Comparison of patients with coronary heart disease and controls in genome-wide association studies has revealed several single nucleotide polymorphisms (SNPs) associated with coronary heart disease. We aimed to establish the external validity of these findings and to obtain more precise risk estimates using a prospective cohort design.We tested 13 recently discovered SNPs for association with coronary heart disease in a case-control design including participants differing from those in the discovery samples (3829 participants with prevalent coronary heart disease and 48,897 controls free of the disease) and a prospective cohort design including 30,725 participants free of cardiovascular disease from Finland and Sweden. We modelled the 13 SNPs as a multilocus genetic risk score and used Cox proportional hazards models to estimate the association of genetic risk score with incident coronary heart disease. For case-control analyses we analysed associations between individual SNPs and quintiles of genetic risk score using logistic regression.In prospective cohort analyses, 1264 participants had a first coronary heart disease event during a median 10·7 years' follow-up (IQR 6·7-13·6). Genetic risk score was associated with a first coronary heart disease event. When compared with the bottom quintile of genetic risk score, participants in the top quintile were at 1·66-times increased risk of coronary heart disease in a model adjusting for traditional risk factors (95% CI 1·35-2·04, p value for linear trend=7·3×10(-10)). Adjustment for family history did not change these estimates. Genetic risk score did not improve C index over traditional risk factors and family history (p=0·19), nor did it have a significant effect on net reclassification improvement (2·2%, p=0·18); however, it did have a small effect on integrated discrimination index (0·004, p=0·0006). Results of the case-control analyses were similar to those of the prospective cohort analyses.Using a genetic risk score based on 13 SNPs associated with coronary heart disease, we can identify the 20% of individuals of European ancestry who are at roughly 70% increased risk of a first coronary heart disease event. The potential clinical use of this panel of SNPs remains to be defined.The Wellcome Trust; Academy of Finland Center of Excellence for Complex Disease Genetics; US National Institutes of Health; the Donovan Family Foundation.

Dataset Information

Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study.

Publications

Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study.

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