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First MI (first + mi)
Selected AbstractsAbstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions: the SHEEP case,control studyADDICTION, Issue 10 2003Anders Romelsjö ABSTRACT Aims, Very few studies indicating that low,moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers. Design, Data came from a case,control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45,70 years old. Setting, Stockholm County 1992,94. Participants, There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population. Measurement, Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls. Findings, In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50,69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1,5 g 100% ethanol/day). Men who were abstainers during the previous 1,10 years and with an earlier average consumption of 5,30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations. Conclusion, Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1,10-year-long abstainers influenced the risk of MI. [source] Variation in 24 hemostatic genes and associations with non-fatal myocardial infarction and ischemic strokeJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2008N. L. SMITH Summary., Background:, Arterial thrombosis involves platelet aggregation and clot formation, yet little is known about the contribution of genetic variation in fibrin-based hemostatic factors to arterial clotting risk. We hypothesized that common variation in 24 coagulation,fibrinolysis genes would contribute to risk of incident myocardial infarction (MI) or ischemic stroke (IS). Methods:, We conducted a population-based, case,control study. Subjects were hypertensive adults and postmenopausal women 30,79 years of age, who sustained a first MI (n = 856) or IS (n = 368) between 1995 and 2002, and controls matched on age, hypertension status, and calendar year (n = 2689). We investigated the risk of MI and IS associated with (i) global variation within each gene as measured by common haplotypes and (ii) individual haplotypes and single nucleotide polymorphisms (SNPs). Significance was assessed using a 0.2 threshold of the false discovery rate q -value, which accounts for multiple testing. Results:, After accounting for multiple testing, global genetic variation in factor (F) VIII was associated with IS risk. Two haplotypes in FVIII and one in FXIIIa1 were significantly associated with increased IS risk (all q -values < 0.2). A plasminogen gene SNP was associated with MI risk. All are new discoveries not previously reported. Another 24 tests had P -values < 0.05 and q -values > 0.2 in MI and IS analyses, 23 of which are new and hypothesis generating. Conclusions:, Apart from the association of FVIII variation with IS, we found little evidence that common variation in the 24 candidate fibrin-based hemostasis genes strongly influences arterial thrombotic risk, but our results cannot rule out small effects. [source] Anti-beta 2 glycoprotein I antibodies and the risk of myocardial infarction in young premenopausal womenJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 12 2007P. L. MERONI Summary Background:,Contrasting data have been reported on the association between the presence of anti-phospholipid antibodies (aPL) and arterial thrombotic events, particularly those in coronary arteries. This discrepancy is perhaps related to the confounding effect of traditional risk factors. Among them, coronary atherosclerosis appears to be the most important in studies conducted in middle-aged and elderly patients.Objective:,To minimize such confounding effects, a multicenter case,control study on the association between aPL and myocardial infarction (MI) was carried out in a rare cohort of young premenopausal women.Methods:,We evaluated 172 cases hospitalized for a first MI before the age of 45 years and 172 controls individually matched with cases for age, sex and geographical origin. Clinical and laboratory data were collected and levels of anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-,2GPI) and anti-nuclear antibodies (ANA) were measured.Results:,A significant association between MI and IgG/IgM anti-,2GPI antibodies was observed; the results were confirmed after adjusting for smoking and hypertension (anti-,2GPI IgG OR = 2.47, 95% CI 1.81,3.38; anti-,2GPI IgM 4th quartile OR 3.68, 95% CI 1.69,8.02). The association between anti-,2GPI antibodies and MI was detected in both subgroups with and without coronary artery stenosis. Whereas the association of aCL IgG with MI was modest, ANA showed no significant association with MI. No aPL were found in unselected patients (mainly males) who recently developed acute MI.Conclusions:,Anti-,2GPI antibodies are a significant risk factor for MI in young premenopausal women independently of other risk factors, including the degree of coronary artery stenosis. [source] Use and adherence to beta-blockers for secondary prevention of myocardial infarction: who is not getting the treatment?,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 11 2004Li Wei Abstract Purpose To characterise those who receive beta-blocker therapy after MI and to estimate the effect of adherence to beta-blocker use on subsequent mortality and recurrent MI. Methods A community-based observational cohort study was done using a record linkage database. Patients were those discharged from hospitals after their first MI between January 1994 and December 1995 and who also survived for at least 1 year. The outcome was all cause mortality and recurrent MI. Results were adjusted for age, sex, social deprivation, airways disease, peripheral vascular disease (PVD), diabetes mellitus, cardiovascular drug use, steroid use and hospitalisation for cardiovascular disease using a logistic regression model and a Cox regression model. Results A total of 865 patients were included in this study. 386 (44.6%) were on beta-blocker treatment during the year after MI. Beta-blocker use was lower amongst high-risk patients (older patients, patients with obstructive airway disease, PVD and those with a previous hospitalisation for heart failure). Mortality was lower in patients treated with beta-blockers compared with those untreated. Good adherence (,80%) was associated with a lower adjusted relative risk of mortality compared with unexposed patients (0.49, 95%CI 0.30,0.80, p,<,0.01). Within the high-risk subgroup of patients, the adjusted relative risk of mortality with good adherence was 0.40 (0.17,0.93, p,=,0.03). Conclusions Beta-blocker use was lower in older patients, patients with airways disease, PVD and heart failure, but these patients appeared to have the greatest benefit from beta-blockers. Good adherence to beta-blocker treatment after MI was associated with a lower risk of mortality. Copyright © 2004 John Wiley & Sons, Ltd. [source] A case-control study of acetaminophen use in relation to the risk of first myocardial infarction in men,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2003Lynn Rosenberg ScD Abstract Purpose Experimental evidence raises the possibility that acetaminophen use could reduce the risk of myocardial infarction (MI). We assessed the relation of acetaminophen use, and also of aspirin use, to first MI in a case-control study. Methods Data on analgesic use and other factors were collected in a hospital-based case-control study of first MI in men under 55 years of age conducted from 1980 to 1983. We compared 2035 men with first MIs to 2656 control men admitted for conditions unrelated to analgesic use. Odds ratios (ORs) for acetaminophen use relative to nonuse were estimated with logistic regression analysis, controlling for major MI risk factors. Results The OR was 0.9 (95% confidence interval (CI): 0.6,1.3) for acetaminophen use at least once a week for at least 3 months, 0.7 (95%CI: 0.4,1.1) for daily use for at least 3 months, and 0.5 (95%CI: 0.2,1.6) for daily use for at least 5 years. In analyses of aspirin use, the OR was 0.9 (95%CI: 0.7,1.2) for use at least once a week for at least 3 moths, 0.9 (95%CI: 0.6,1.2) for daily use lasting at least 3 months, 0.6 (95%CI: 0.4,1.1) for daily use for at least 5 years, and 0.4 (95%CI: 0.2,1.0) for daily use for at least 10 years. Conclusions While our results raise the possibility of a protective effect of long-term regular acetaminophen use against first MI, they are compatible with no effect. The data suggest a potential protective effect of long-term regular aspirin use. Copyright © 2003 John Wiley & Sons, Ltd. [source] | ||||||||||