期刊
AMERICAN HEART JOURNAL
卷 152, 期 3, 页码 461-468出版社
MOSBY, INC
DOI: 10.1016/j.ahj.2006.02.003
关键词
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资金
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL072435, R01HL059205] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [R01AR030582] Funding Source: NIH RePORTER
- NHLBI NIH HHS [R01 HL 59205, R01 HL 72435] Funding Source: Medline
- NIAMS NIH HHS [AR30582] Funding Source: Medline
Background Sex-specific data on classic risk factors and their impact after myocardial infarction (MI) in the community are locking. We evaluated the prevalence and association of classic risk factors with recurrent ischernic events in patients with MI and tested the hypothesis that they differed by sex. Methods All patients (1104, 45% women) from Olmsted County, Minnesota, hospitalized with an incident MI between 1990 and 1998 were identified using standardized criteria and followed-up (mean 3.7 years) for recurrent ischernic events, defined as recurrent MI, ischemic stroke, or coronary death. Data on hypertension, diabetes, hypercholesterolemia, smoking, and obesity at index hospitalization were analyzed individually and in clusters. Results Women were older than men (73 vs 64 years, P < .001) and had more risk factors. During follow-up, 423 events occurred. For women, the adjusted risk of recurrent events increased with hypertension, diabetes, and hypercholesterolemia. For men, no increase in risk was detected with any risk factor. The population attributable risk of all risk factors, combined was 46% (95% CI 29%-62%),in women and 19% (95% CI 6%-35%) in men. As the number of risk factors increased from 1 to >= 4, compared with no risk factors, the adjusted hazard ratio in women increased progressively (1.12, 1.82, 2.34, and 2.68, respectively), whereas no,trend was detected in men (1.40, 1.27, 1.24, and 1.37, respectively) (P = .01 for effect modification by sex). Conclusions Classic risk factors are highly prevalent and often clustered in MI, especially among women. Although their predictive value for recurrent ischernic events is marginal in men, strong associations exist in women, which define secondary prevention opportunities.
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