Document Detail

Risk for early ischemic event after acute myocardial infarction in working males.
MedLine Citation:
PMID:  12038863     Owner:  NLM     Status:  MEDLINE    
We attempt to predict ischemic events in the weeks following the hospital discharge after acute myocardial infarction (AMI) in order to aid occupational physicians in taking return-to-work decisions. Included in the study were 1299 AMI patients from 14 coronary care units in Israel who had been employed before hospitalization and were seen after discharge 1, 2, 4, 6, 9 and 12 months after the first AMI. Cardiovascular accidents included death from cardiovascular disease, recurrent infarction or hospitalization due to congestive heart failure or unstable angina. The rate of a first recurrent cardiovascular accident decreased rapidly over the first few weeks. The risk in the third week was still 51 per 1000 person-months, 13.4 (95% CI: 9.2-19.5) times higher than that after 10 weeks when the incidence reached a low steady state. The major predictors in a logistic regression model for an event were: older age, past history of a cerebrovascular event, and congestive heart failure during the course of hospitalization, but the area under the receiver-operator curve was only 64.4%. We conclude that after acute myocardial infarction, the major risk for a recurrent event is a lapse of time from discharge but not other clinical variables. This should be taken into account when considering a proper timing of return-to-work after an acute myocardial infarction.
Paul Froom; Dafna Gofer; Valentina Boyko; Uri Goldbourt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of occupational medicine and environmental health     Volume:  15     ISSN:  1232-1087     ISO Abbreviation:  Int J Occup Med Environ Health     Publication Date:  2002  
Date Detail:
Created Date:  2002-05-31     Completed Date:  2002-06-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9437093     Medline TA:  Int J Occup Med Environ Health     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  43-8     Citation Subset:  IM    
National Institute of Occupational and Environmental Health, Raanana, Israel.
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MeSH Terms
Decision Making
Health Status
Middle Aged
Myocardial Infarction / complications*
Myocardial Ischemia / etiology*,  pathology
Patient Discharge
Risk Factors
Time Factors

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