Document Detail

Body mass index and preinfarction angina in elderly patients with acute myocardial infarction.
MedLine Citation:
PMID:  14522739     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preinfarction angina, a clinical equivalent of ischemic preconditioning, seems to protect against in-hospital death, cardiogenic shock, and the combined endpoints in adult but not in elderly patients with acute myocardial infarction. Experimental evidence indicates that caloric restriction may restore ischemic preconditioning in aged animals. OBJECTIVE: The objective was to verify whether body mass index (BMI) influences the cardioprotective effect of preinfarction angina in the elderly. DESIGN: We retrospectively studied 820 patients aged >/= 65 y with acute myocardial infarction by evaluating BMI and major (death and cardiogenic shock) and minor in-hospital outcomes. RESULTS: In-hospital death, cardiogenic shock, and the combined endpoints were not significantly different between elderly patients with and without preinfarction angina. Interestingly, in-hospital death, cardiogenic shock, and the combined endpoints were significantly fewer in elderly patients with than without preinfarction angina in the subset of patients with the lowest BMI (P < 0.01, < 0.01, and < 0.01, respectively). Regression analysis showed that preinfarction angina did not protect against in-hospital death when analyzed in all patients independently of BMI, whereas it was protective in the subset of patients with the lowest BMI (odds ratio: 0.06; 95% CI: 0.00, 0.54). CONCLUSIONS: Preinfarction angina does not protect against in-hospital death, cardiogenic shock, or the combined endpoints in elderly patients with acute myocardial infarction. With stratification by quartiles of BMI, the protective effect of preinfarction angina is preserved in elderly patients with the lowest BMI.
Pasquale Abete; Francesco Cacciatore; Nicola Ferrara; Claudio Calabrese; Domenico de Santis; Gianluca Testa; Gianluigi Galizia; Stefania Del Vecchio; Dario Leosco; Mario Condorelli; Claudio Napoli; Franco Rengo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  78     ISSN:  0002-9165     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-02     Completed Date:  2003-10-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  796-801     Citation Subset:  AIM; IM    
Cattedra di Geriatria, Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Naples Federico II, Naples, Italy.
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MeSH Terms
Angina, Unstable / complications*
Body Mass Index*
Coronary Care Units
Hospital Mortality
Myocardial Infarction / complications*

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