History of Blood Transfusion before 1990 Is a Risk Factor for Stroke and Cardiovascular Diseases: The Japan Collaborative Cohort Study (JACC Study)

Vol. 20, No. 3, 2005

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Original Paper

History of Blood Transfusion before 1990 Is a Risk Factor for Stroke and Cardiovascular Diseases: The Japan Collaborative Cohort Study (JACC Study)
Shigeki Yamada^{a, b}, Akio Koizumi^a, Hiroyasu Iso^c, Yasuhiko Wada^d, Yoshiyuki Watanabe^e, Chigusa Date^f, Akio Yamamoto^g, Shogo Kikuchi^h, Yutaka Inabaⁱ, Takaaki Kondo^j, Hideaki Toyoshima^k, Akiko Tamakoshi^l, and the JACC Study Group

Departments of
^aHealth and Environmental Sciences and
^bNeurosurgery, Kyoto University Graduate School of Medicine, Kyoto;
^cPublic Health Medicine, Institute of Community Medicine, University of Tsukuba, Ibaraki;
^dHygiene, Hyogo College of Medicine, Hyogo;
^eSocial Medicine & Cultural Sciences, Research Institute for Neurological Diseases & Geriatrics, Kyoto Prefectural University of Medicine, Kyoto;
^fNutrition and Food Sciences, Mukogawa Women's University, Hyogo;
^gInfectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Sciences, Hyogo;
^hPublic Health, Aichi Medical University, Aichi;
ⁱPublic Health, Juntendo University School of Medicine, Tokyo;
^jMedical Technology, Nagoya University School of Health Sciences, Nagoya;
^kPublic Health/Health Information Dynamics, and
^lPreventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan

Address of Corresponding Author

Cerebrovasc Dis 2005;20:164-171 (DOI: 10.1159/000087200)

Key Words

Transfusion history
Epidemiology
Stroke
Coronary heart disease
Follow-up study

Abstract

Background: We have previously shown novel evidence that history of blood transfusion is a risk factor for mortality from subarachnoid hemorrhage. This study was conducted to assess history of transfusion as a risk factor for other hemorrhagic stroke or ischemic stroke and cardiovascular diseases. Study Design and Methods: A total of 88,312 Japanese participants (36,823 men and 51,489 women), aged 40-79 years, without history of stroke, heart disease or cancer, completed a questionnaire including history of transfusion under the JACC Study from 1988 to 1990. Participants were followed up annually until deceased, or when they moved away from the surveyed community, or at the end of 1999. The underlying causes of death were determined according to the International Classification of Diseases, 10th revision (ICD-10). Results: Total follow-up person-years were 871,437 (males 359,437, females 512,000). During this 10-year period, 309 died from intracerebral hemorrhage, 587 from ischemic stroke and 472 from coronary heart disease. The multivariate relative risks of a transfusion history were 2.16 (95% CI 1.42-3.27, p < 0.001) for intracerebral hemorrhage, 1.63 (95% CI 1.18-2.27, p = 0.004) for ischemic stroke and 1.66 (95% CI 1.17-2.36, p = 0.005) for coronary heart disease, after adjustment for conventional cardiovascular risk factors. Conclusion: A transfusion history was associated with increased mortality from stroke and coronary heart disease.

Author Contacts

Prof. Akio Koizumi, MD, PhD
Department of Health and Environmental Sciences
Kyoto University Graduate School of Medicine
Konoe-cho, Yoshida, Sakyo-ku, Kyoto 606-8501 (Japan)
Tel. +81 75 7534456, Fax +81 75 7534458, E-Mail koizumi@pbh.med.kyoto-u.ac.jp

Article Information

S.Y. and A.K. analyzed the data and wrote the manuscript. A.K., H.I., Y. Wada, Y. Watanabe, C.D., A.Y., S.K., Y.I., T.K., H.T., A.T. and the members of the JACC Study Group (listed in the Appendix) contributed to the data entry, data management, and follow-up of the cohort. All authors contributed to preparing the manuscript. A.T. was the present chief of the JACC Study.

Received: January 18, 2005
Accepted: April 18, 2005
Published online: July 27, 2005
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 5, Number of References : 43

Medline Abstract (ID 16088111)

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