Document Detail

Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction.
MedLine Citation:
PMID:  22089719     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Few studies have examined the association between the number of coronary heart disease risk factors and outcomes of acute myocardial infarction in community practice.
OBJECTIVE: To determine the association between the number of coronary heart disease risk factors in patients with first myocardial infarction and hospital mortality.
DESIGN: Observational study from the National Registry of Myocardial Infarction, 1994-2006.
PATIENTS: We examined the presence and absence of 5 major traditional coronary heart disease risk factors (hypertension, smoking, dyslipidemia, diabetes, and family history of coronary heart disease) and hospital mortality among 542,008 patients with first myocardial infarction and without prior cardiovascular disease.
MAIN OUTCOME MEASURE: All-cause in-hospital mortality.
RESULTS: A majority (85.6%) of patients who presented with initial myocardial infarction had at least 1 of the 5 coronary heart disease risk factors, and 14.4% had none of the 5 risk factors. Age varied inversely with the number of coronary heart disease risk factors, from a mean age of 71.5 years with 0 risk factors to 56.7 years with 5 risk factors (P for trend < .001). The total number of in-hospital deaths for all causes was 50,788. Unadjusted in-hospital mortality rates were 14.9%, 10.9%, 7.9%, 5.3%, 4.2%, and 3.6% for patients with 0, 1, 2, 3, 4, and 5 risk factors, respectively. After adjusting for age and other clinical factors, there was an inverse association between the number of coronary heart disease risk factors and hospital mortality adjusted odds ratio (1.54; 95% CI, 1.23-1.94) among individuals with 0 vs 5 risk factors. This association was consistent among several age strata and important patient subgroups.
CONCLUSION: Among patients with incident acute myocardial infarction without prior cardiovascular disease, in-hospital mortality was inversely related to the number of coronary heart disease risk factors.
John G Canto; Catarina I Kiefe; William J Rogers; Eric D Peterson; Paul D Frederick; William J French; C Michael Gibson; Charles V Pollack; Joseph P Ornato; Robert J Zalenski; Jan Penney; Alan J Tiefenbrunn; Philip Greenland;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  306     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-17     Completed Date:  2011-12-07     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2120-7     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Aged, 80 and over
Coronary Disease / epidemiology*
Diabetes Mellitus
Genetic Predisposition to Disease
Hospital Mortality*
Middle Aged
Myocardial Infarction / mortality*
Registries / statistics & numerical data
Risk Factors*
United States / epidemiology
Grant Support
Comment In:
JAMA. 2012 Mar 21;307(11):1137; author reply 1138   [PMID:  22436947 ]
JAMA. 2012 Mar 21;307(11):1137-8; author reply 1138   [PMID:  22436948 ]

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