Atherosclerotic Risk Factors and Their Association With Hospital Mortality Among Patients With First Myocardial Infarction (from the National Registry of Myocardial Infarction)
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Authors
Canto, John G.Kiefe, Catarina I.
Rogers, William J.
Peterson, Eric D.
Frederick, Paul D.
French, William J.
Gibson, C. Michael
Pollack, Charles V. Jr.
Ornato, Joseph P.
Zalenski, Robert J.
Penney, Jan
Tiefenbrunn, Alan J.
Greenland, Philip
NRMI Investigators
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2012-11-01Keywords
Myocardial InfarctionAtherosclerosis
Risk Factors
Hospital Mortality
UMCCTS funding
Cardiology
Cardiovascular Diseases
Epidemiology
Health Services Research
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Show full item recordAbstract
Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics.Source
Am J Cardiol. 2012 Nov 1;110(9):1256-61. doi: 10.1016/j.amjcard.2012.06.025. Link to article on publisher's site
DOI
10.1016/j.amjcard.2012.06.025Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46545PubMed ID
22840346Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.amjcard.2012.06.025