Document Detail

Vitality and recurrent event risk in acute myocardial infarction survivors.
MedLine Citation:
PMID:  19474738     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Low vitality, characterized by fatigue and lack of energy, is common among survivors of acute myocardial infarction (AMI) and has been shown to be associated with increased risk of primary and secondary cardiac events. The goal of this study was to determine whether an association between vitality and recurrent cardiac events (nonfatal MI, cardiac death) among acute MI survivors persists after controlling for possible physiological and psychological confounders. DESIGN AND METHODS: Incident AMI survivors (n = 1328) from Erie and Niagara (New York) county hospitals were enrolled and followed up to 9 years. Vitality was measured by the Short Form-36 on a 0-100 scale approximately 4 months post-AMI. Cox proportional hazards models were developed to assess the vitality-recurrent event association controlling for traditional cardiovascular disease risk factors, index MI severity, and psychological correlates of vitality. RESULTS: Low-vitality individuals at baseline were more likely females, of higher BMI, smoking, diabetic, less physically active, and to have worse depression scores. Vitality was not strongly associated with MI severity markers. Lower vitality scores were associated with increased risk of recurrent cardiac events: adjusted hazard ratios (95% CI) for vitality scores 51-79, 21-50, and < or =20 (compared with > or =80) were 1.2 (0.8, 1.8), 1.4 (0.9, 2.2), and 2.9 (1.5, 5.4), respectively (Ptrend = 0.005). CONCLUSION: Low vitality was associated with increased risk of recurrent cardiac events among AMI survivors after controlling for physiological and psychological confounders. Mechanistic links with vitality should be sought as interventional targets.
Brent A Williams; Joan M Dorn; Richard P Donahue; Kathleen M Hovey; Lisa B Rafalson; Maurizio Trevisan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  16     ISSN:  1741-8275     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  499-505     Citation Subset:  IM    
Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY 14214-8001, USA.
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MeSH Terms
Activities of Daily Living
Chi-Square Distribution
Fatigue / physiopathology*
Interviews as Topic
Middle Aged
Myocardial Infarction / physiopathology*,  psychology
New York
Proportional Hazards Models
Risk Factors
Statistics, Nonparametric
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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