Is #gout a risk equivalent to diabetes for #stroke and myocardial #infarction? A retrospective claims database study
https://link.springer.com/article/10.1186/s13075-017-1427-5
Gout is a risk factor for cardiovascular disease, but associations with specific cardiovascular outcomes, myocardial infarction (MI), and stroke are unclear. Our objective in the present study was to assess whether gout is as strong a risk factor as diabetes mellitus (DM) for incident MI and incident stroke The incidence of acute MI was lowest in patients with neither gout nor DM, followed by patients with gout alone, DM alone, and both. Among men >80 years of age, the respective rates/1000 person-years were 14.6, 25.4, 27.7, and 37.4. Similar trends were noted for stroke and in women. Compared with DM only, gout was associated with a significantly lower adjusted HR of incident MI (HR 0.81, 95% CI 0.76–0.87) but a similar risk of stroke (HR 1.02, 95% CI 0.95–1.10). Compared with patients with DM only, patients with both gout and DM had higher HRs for incident MI and stroke (respectively, HR 1.35, 95% CI 1.25–1.47; HR 1.42, 95% CI 1.29–1.56).
Conclusions
Gout is a risk equivalent to DM for incident stroke but not for incident MI. Having both gout and DM confers incremental risk compared with DM alone for both incident MI and stroke
https://link.springer.com/article/10.1186/s13075-017-1427-5
Gout is a risk factor for cardiovascular disease, but associations with specific cardiovascular outcomes, myocardial infarction (MI), and stroke are unclear. Our objective in the present study was to assess whether gout is as strong a risk factor as diabetes mellitus (DM) for incident MI and incident stroke The incidence of acute MI was lowest in patients with neither gout nor DM, followed by patients with gout alone, DM alone, and both. Among men >80 years of age, the respective rates/1000 person-years were 14.6, 25.4, 27.7, and 37.4. Similar trends were noted for stroke and in women. Compared with DM only, gout was associated with a significantly lower adjusted HR of incident MI (HR 0.81, 95% CI 0.76–0.87) but a similar risk of stroke (HR 1.02, 95% CI 0.95–1.10). Compared with patients with DM only, patients with both gout and DM had higher HRs for incident MI and stroke (respectively, HR 1.35, 95% CI 1.25–1.47; HR 1.42, 95% CI 1.29–1.56).
Conclusions
Gout is a risk equivalent to DM for incident stroke but not for incident MI. Having both gout and DM confers incremental risk compared with DM alone for both incident MI and stroke
SpringerLink
Is gout a risk equivalent to diabetes for stroke and myocardial infarc
Gout is a risk factor for cardiovascular disease, but associations with specific cardiovascular outcomes, myocardial infarction (MI), and stroke are unclear. Our objective in the present study was to
Henry Ford HEART #Score Randomized Trial
Rapid Discharge of Patients Evaluated for Possible Myocardial #Infarction
http://circoutcomes.ahajournals.org/content/10/10/e003617
Hospital evaluation of patients with chest pain is common and costly. The HEART score risk stratification tool that merges troponin testing into a clinical risk model for evaluation emergency department patients with possible acute myocardial infarction (AMI) has been shown to effectively identify a substantial low-risk subset of patients possibly safe for early discharge without stress testing, a strategy that could have tremendous healthcare savings implications.
Method and Results—A total of 105 patients evaluated for AMI in the emergency departments of 2 teaching hospitals in the Henry Ford Health System (Detroit and West Bloomfield, MI), between February 2014 and May 2015, with a modified HEART score ≤3 (which includes cardiac troponin I <0.04 ng/mL at 0 and 3 hours) were randomized to immediate discharge (n=53) versus management in an observation unit with stress testing (n=52). The primary end points were 30-day total charges and length of stay. Secondary end points were all-cause death, nonfatal AMI, rehospitalization for evaluation of possible AMI, and coronary revascularization at 30 days. Patients randomized to early discharge, compared with those who were admitted for observation and cardiac testing, spent less time in the hospital (median 6.3 hours versus 25.9 hours; P<0.001) with an associated reduction in median total charges of care ($2953 versus $9616; P<0.001). There were no deaths, AMIs, or coronary revascularizations in either group. One patient in each group was lost to follow-up.
Conclusions—Among patients evaluated for possible AMI in the emergency department with a modified HEART score ≤3, early discharge without stress testing as compared with transfer to an observation unit for stress testing was associated with significant reductions in length of stay and total charges, a finding that has tremendous potential national healthcare expenditure implications
Rapid Discharge of Patients Evaluated for Possible Myocardial #Infarction
http://circoutcomes.ahajournals.org/content/10/10/e003617
Hospital evaluation of patients with chest pain is common and costly. The HEART score risk stratification tool that merges troponin testing into a clinical risk model for evaluation emergency department patients with possible acute myocardial infarction (AMI) has been shown to effectively identify a substantial low-risk subset of patients possibly safe for early discharge without stress testing, a strategy that could have tremendous healthcare savings implications.
Method and Results—A total of 105 patients evaluated for AMI in the emergency departments of 2 teaching hospitals in the Henry Ford Health System (Detroit and West Bloomfield, MI), between February 2014 and May 2015, with a modified HEART score ≤3 (which includes cardiac troponin I <0.04 ng/mL at 0 and 3 hours) were randomized to immediate discharge (n=53) versus management in an observation unit with stress testing (n=52). The primary end points were 30-day total charges and length of stay. Secondary end points were all-cause death, nonfatal AMI, rehospitalization for evaluation of possible AMI, and coronary revascularization at 30 days. Patients randomized to early discharge, compared with those who were admitted for observation and cardiac testing, spent less time in the hospital (median 6.3 hours versus 25.9 hours; P<0.001) with an associated reduction in median total charges of care ($2953 versus $9616; P<0.001). There were no deaths, AMIs, or coronary revascularizations in either group. One patient in each group was lost to follow-up.
Conclusions—Among patients evaluated for possible AMI in the emergency department with a modified HEART score ≤3, early discharge without stress testing as compared with transfer to an observation unit for stress testing was associated with significant reductions in length of stay and total charges, a finding that has tremendous potential national healthcare expenditure implications
Circulation: Cardiovascular Quality and Outcomes
Henry Ford HEART Score Randomized Trial
Background— Hospital evaluation of patients with chest pain is common and costly. The HEART score risk stratification tool that merges troponin testing into a clinical risk model for evaluation emergency department patients with possible acute myocardial…
Acute Myocardial #Infarction after Laboratory-Confirmed #Influenza Infection
http://www.nejm.org/doi/full/10.1056/NEJMoa1702090
We identified 364 hospitalizations for acute myocardial infarction that occurred within 1 year before and 1 year after a positive test result for influenza. Of these, 20 (20.0 admissions per week) occurred during the risk interval and 344 (3.3 admissions per week) occurred during the control interval. The incidence ratio of an admission for acute myocardial infarction during the risk interval as compared with the control interval was 6.05 (95% confidence interval CI, 3.86 to 9.50). No increased incidence was observed after day 7. Incidence ratios for acute myocardial infarction within 7 days after detection of influenza B, influenza A, respiratory syncytial virus, and other viruses were 10.11 (95% CI, 4.37 to 23.38), 5.17 (95% CI, 3.02 to 8.84), 3.51 (95% CI, 1.11 to 11.12), and 2.77 (95% CI, 1.23 to 6.24), respectively.
CONCLUSIONS
We found a significant association between respiratory infections, especially influenza, and acute myocardial infarction
..The risk was especially pronounced in older patients and was independent of flu vaccination status or history of MI hospitalization. There was also a signal that other forms of respiratory infection can similarly raise the risk for MI admission
http://www.nejm.org/doi/full/10.1056/NEJMoa1702090
We identified 364 hospitalizations for acute myocardial infarction that occurred within 1 year before and 1 year after a positive test result for influenza. Of these, 20 (20.0 admissions per week) occurred during the risk interval and 344 (3.3 admissions per week) occurred during the control interval. The incidence ratio of an admission for acute myocardial infarction during the risk interval as compared with the control interval was 6.05 (95% confidence interval CI, 3.86 to 9.50). No increased incidence was observed after day 7. Incidence ratios for acute myocardial infarction within 7 days after detection of influenza B, influenza A, respiratory syncytial virus, and other viruses were 10.11 (95% CI, 4.37 to 23.38), 5.17 (95% CI, 3.02 to 8.84), 3.51 (95% CI, 1.11 to 11.12), and 2.77 (95% CI, 1.23 to 6.24), respectively.
CONCLUSIONS
We found a significant association between respiratory infections, especially influenza, and acute myocardial infarction
..The risk was especially pronounced in older patients and was independent of flu vaccination status or history of MI hospitalization. There was also a signal that other forms of respiratory infection can similarly raise the risk for MI admission
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#Cocaine and #Marijuana Use Among Young Adults With Myocardial #Infarction
http://www.onlinejacc.org/content/71/22/2540
A total of 2,097 patients had type 1 MI (mean age 44.0 ± 5.1 years, 19.3% female, 73% white), with median follow-up of 11.2 years (interquartile range: 7.3 to 14.2 years). Use of cocaine and/or marijuana was present in 224 (10.7%) patients; cocaine in 99 (4.7%) patients, and marijuana in 125 (6.0%). Individuals with substance use had significantly lower rates of diabetes (14.7% vs. 20.4%; p = 0.05) and hyperlipidemia (45.7% vs. 60.8%; p < 0.001), but they were significantly more likely to use tobacco (70.3% vs. 49.1%; p < 0.001). The use of cocaine and/or marijuana was associated with significantly higher cardiovascular mortality (hazard ratio: 2.22; 95% confidence interval: 1.27 to 3.70; p = 0.005) and all-cause mortality (hazard ratio: 1.99; 95% confidence interval: 1.35 to 2.97; p = 0.001) after adjusting for baseline covariates.
Conclusions Cocaine and/or marijuana use is present in 10% of patients with an MI at age ≤50 years and is associated with worse all-cause and cardiovascular mortality. These findings reinforce current recommendations for substance use screening among young adults with an MI, and they highlight the need for counseling to prevent future adverse events
#Cocaine and #Marijuana Use Among Young Adults With Myocardial #Infarction
http://www.onlinejacc.org/content/71/22/2540
A total of 2,097 patients had type 1 MI (mean age 44.0 ± 5.1 years, 19.3% female, 73% white), with median follow-up of 11.2 years (interquartile range: 7.3 to 14.2 years). Use of cocaine and/or marijuana was present in 224 (10.7%) patients; cocaine in 99 (4.7%) patients, and marijuana in 125 (6.0%). Individuals with substance use had significantly lower rates of diabetes (14.7% vs. 20.4%; p = 0.05) and hyperlipidemia (45.7% vs. 60.8%; p < 0.001), but they were significantly more likely to use tobacco (70.3% vs. 49.1%; p < 0.001). The use of cocaine and/or marijuana was associated with significantly higher cardiovascular mortality (hazard ratio: 2.22; 95% confidence interval: 1.27 to 3.70; p = 0.005) and all-cause mortality (hazard ratio: 1.99; 95% confidence interval: 1.35 to 2.97; p = 0.001) after adjusting for baseline covariates.
Conclusions Cocaine and/or marijuana use is present in 10% of patients with an MI at age ≤50 years and is associated with worse all-cause and cardiovascular mortality. These findings reinforce current recommendations for substance use screening among young adults with an MI, and they highlight the need for counseling to prevent future adverse events
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Coronary CT #Angiography and 5-Year Risk of Myocardial #Infarction
https://www.nejm.org/doi/full/10.1056/NEJMoa1805971
The median duration of follow-up was 4.8 years, which yielded 20,254 patient-years of follow-up. The 5-year rate of the primary end point was lower in the CTA group than in the standard-care group (2.3% 48 patients vs. 3.9% 81 patients; hazard ratio, 0.59; 95% confidence interval CI, 0.41 to 0.84; P=0.004). Although the rates of invasive coronary angiography and coronary revascularization were higher in the CTA group than in the standard-care group in the first few months of follow-up, overall rates were similar at 5 years: invasive coronary angiography was performed in 491 patients in the CTA group and in 502 patients in the standard-care group (hazard ratio, 1.00; 95% CI, 0.88 to 1.13), and coronary revascularization was performed in 279 patients in the CTA group and in 267 in the standard-care group (hazard ratio, 1.07; 95% CI, 0.91 to 1.27). However, more preventive therapies were initiated in patients in the CTA group (odds ratio, 1.40; 95% CI, 1.19 to 1.65), as were more antianginal therapies (odds ratio, 1.27; 95% CI, 1.05 to 1.54). There were no significant between-group differences in the rates of cardiovascular or noncardiovascular deaths or deaths from any cause.
CONCLUSIONS
In this trial, the use of CTA in addition to standard care in patients with stable chest pain resulted in a significantly lower rate of death from coronary heart disease or nonfatal myocardial infarction at 5 years than standard care alone, without resulting in a significantly higher rate of coronary angiography or coronary revascularization
Coronary CT #Angiography and 5-Year Risk of Myocardial #Infarction
https://www.nejm.org/doi/full/10.1056/NEJMoa1805971
The median duration of follow-up was 4.8 years, which yielded 20,254 patient-years of follow-up. The 5-year rate of the primary end point was lower in the CTA group than in the standard-care group (2.3% 48 patients vs. 3.9% 81 patients; hazard ratio, 0.59; 95% confidence interval CI, 0.41 to 0.84; P=0.004). Although the rates of invasive coronary angiography and coronary revascularization were higher in the CTA group than in the standard-care group in the first few months of follow-up, overall rates were similar at 5 years: invasive coronary angiography was performed in 491 patients in the CTA group and in 502 patients in the standard-care group (hazard ratio, 1.00; 95% CI, 0.88 to 1.13), and coronary revascularization was performed in 279 patients in the CTA group and in 267 in the standard-care group (hazard ratio, 1.07; 95% CI, 0.91 to 1.27). However, more preventive therapies were initiated in patients in the CTA group (odds ratio, 1.40; 95% CI, 1.19 to 1.65), as were more antianginal therapies (odds ratio, 1.27; 95% CI, 1.05 to 1.54). There were no significant between-group differences in the rates of cardiovascular or noncardiovascular deaths or deaths from any cause.
CONCLUSIONS
In this trial, the use of CTA in addition to standard care in patients with stable chest pain resulted in a significantly lower rate of death from coronary heart disease or nonfatal myocardial infarction at 5 years than standard care alone, without resulting in a significantly higher rate of coronary angiography or coronary revascularization
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Association of #Weather With Day-to-Day Incidence of Myocardial #Infarction
https://jamanetwork.com/journals/jamacardiology/article-abstract/2706610
In 274 029 patients, mean (SD) age was 71.7 (12) years. Incidence of MI increased with lower air temperature, lower atmospheric air pressure, higher wind velocity, and shorter sunshine duration. The most pronounced association was observed for air temperature, where a 1-SD increase in air temperature (7.4°C) was associated with a 2.8% reduction in risk of MI (unadjusted incidence ratio, 0.972; 95% CI, 0.967-0.977; P <.001). Results were consistent for non–ST-elevation MI as well as ST-elevation MI and across a large range of subgroups and health care regions.
Conclusions and Relevance In this large, nationwide study, low air temperature, low atmospheric air pressure, high wind velocity, and shorter sunshine duration were associated with risk of MI with the most evident association observed for air temperature.
Association of #Weather With Day-to-Day Incidence of Myocardial #Infarction
https://jamanetwork.com/journals/jamacardiology/article-abstract/2706610
In 274 029 patients, mean (SD) age was 71.7 (12) years. Incidence of MI increased with lower air temperature, lower atmospheric air pressure, higher wind velocity, and shorter sunshine duration. The most pronounced association was observed for air temperature, where a 1-SD increase in air temperature (7.4°C) was associated with a 2.8% reduction in risk of MI (unadjusted incidence ratio, 0.972; 95% CI, 0.967-0.977; P <.001). Results were consistent for non–ST-elevation MI as well as ST-elevation MI and across a large range of subgroups and health care regions.
Conclusions and Relevance In this large, nationwide study, low air temperature, low atmospheric air pressure, high wind velocity, and shorter sunshine duration were associated with risk of MI with the most evident association observed for air temperature.
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#Sex differences in risk factors for myocardial #infarction: cohort study of UK Biobank participants
https://www.bmj.com/content/363/bmj.k4247
.. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MI in men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were associated with higher hazard ratios for MI compared with men: ratio of hazard ratios 1.09 (95% confidence interval 1.02 to 1.16) for systolic blood pressure, 1.55 (1.32 to 1.83) for current smoking, 2.91 (1.56 to 5.45) for type 1 diabetes, and 1.47 (1.16 to 1.87) for type 2 diabetes. There was no evidence that any of these ratios of hazard ratios decreased with age (P>0.2). With the exception of type 1 diabetes, the incidence of MI was higher in men than in women for all risk factors.
Conclusions Although the incidence of MI was higher in men than in women, several risk factors were more strongly associated with MI in women compared with men. Sex specific associations between risk factors and MI declined with age, but, where it occurred, the higher relative risk in women remained. As the population ages and the prevalence of lifestyle associated risk factors increase, the incidence of MI in women will likely become more similar to that in men.
#Sex differences in risk factors for myocardial #infarction: cohort study of UK Biobank participants
https://www.bmj.com/content/363/bmj.k4247
.. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MI in men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were associated with higher hazard ratios for MI compared with men: ratio of hazard ratios 1.09 (95% confidence interval 1.02 to 1.16) for systolic blood pressure, 1.55 (1.32 to 1.83) for current smoking, 2.91 (1.56 to 5.45) for type 1 diabetes, and 1.47 (1.16 to 1.87) for type 2 diabetes. There was no evidence that any of these ratios of hazard ratios decreased with age (P>0.2). With the exception of type 1 diabetes, the incidence of MI was higher in men than in women for all risk factors.
Conclusions Although the incidence of MI was higher in men than in women, several risk factors were more strongly associated with MI in women compared with men. Sex specific associations between risk factors and MI declined with age, but, where it occurred, the higher relative risk in women remained. As the population ages and the prevalence of lifestyle associated risk factors increase, the incidence of MI in women will likely become more similar to that in men.
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#Electronic Cigarette Use and Myocardial #Infarction Among Adults in the US Population Assessment of Tobacco and Health
https://www.ahajournals.org/doi/10.1161/JAHA.119.012317
Every‐day (adjusted odds ratio, 2.25, 95% CI: 1.23–4.11) and some‐day (1.99, 95% CI: 1.11–3.58) e‐cigarette use were independently associated with increased odds of having had an MI with a significant dose‐response (P<0.0005). Odds ratio for daily dual use of both products was 6.64 compared with a never cigarette smoker who never used e‐cigarettes. Having had a myocardial infarction at Wave 1 did not predict e‐cigarette use at Wave 2 (P>0.62), suggesting that reverse causality cannot explain the cross‐sectional association between e‐cigarette use and MI observed at Wave 1.
Conclusions
Some‐day and every‐day e‐cigarette use are associated with increased risk of having had a myocardial infarction, adjusted for combustible cigarette smoking. Effect of e‐cigarettes are similar as conventional cigarette and dual use of e‐cigarettes and conventional cigarettes at the same time is risker than using either product alone.
#Electronic Cigarette Use and Myocardial #Infarction Among Adults in the US Population Assessment of Tobacco and Health
https://www.ahajournals.org/doi/10.1161/JAHA.119.012317
Every‐day (adjusted odds ratio, 2.25, 95% CI: 1.23–4.11) and some‐day (1.99, 95% CI: 1.11–3.58) e‐cigarette use were independently associated with increased odds of having had an MI with a significant dose‐response (P<0.0005). Odds ratio for daily dual use of both products was 6.64 compared with a never cigarette smoker who never used e‐cigarettes. Having had a myocardial infarction at Wave 1 did not predict e‐cigarette use at Wave 2 (P>0.62), suggesting that reverse causality cannot explain the cross‐sectional association between e‐cigarette use and MI observed at Wave 1.
Conclusions
Some‐day and every‐day e‐cigarette use are associated with increased risk of having had a myocardial infarction, adjusted for combustible cigarette smoking. Effect of e‐cigarettes are similar as conventional cigarette and dual use of e‐cigarettes and conventional cigarettes at the same time is risker than using either product alone.
Journal of the American Heart Association
Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health | Journal…
BackgroundE‐cigarettes are popular for smoking cessation and as an alternative to combustible cigarettes. We assess the association between e‐cigarette use and having had a myocardial infarction (M...
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Efficacy and Safety of Low-Dose #Colchicine after Myocardial #Infarction
We performed a randomized, double-blind trial involving patients recruited within 30 days after a myocardial infarction. The patients were randomly assigned to receive either low-dose colchicine (0.5 mg once daily) or placebo..
..The primary end point occurred in 5.5% of the patients in the colchicine group, as compared with 7.1% of those in the placebo group (hazard ratio, 0.77; 95% confidence interval [CI], 0.61 to 0.96; P=0.02). The hazard ratios were 0.84 (95% CI, 0.46 to 1.52) for death from cardiovascular causes, 0.83 (95% CI, 0.25 to 2.73) for resuscitated cardiac arrest, 0.91 (95% CI, 0.68 to 1.21) for myocardial infarction, 0.26 (95% CI, 0.10 to 0.70) for stroke, and 0.50 (95% CI, 0.31 to 0.81) for urgent hospitalization for angina leading to coronary revascularization. Diarrhea was reported in 9.7% of the patients in the colchicine group and in 8.9% of those in the placebo group (P=0.35). Pneumonia was reported as a serious adverse event in 0.9% of the patients in the colchicine group and in 0.4% of those in the placebo group (P=0.03).
CONCLUSIONS
Among patients with a recent myocardial infarction, colchicine at a dose of 0.5 mg daily led to a significantly lower risk of ischemic cardiovascular events than placebo
https://bit.ly/35Z6plV
Efficacy and Safety of Low-Dose #Colchicine after Myocardial #Infarction
We performed a randomized, double-blind trial involving patients recruited within 30 days after a myocardial infarction. The patients were randomly assigned to receive either low-dose colchicine (0.5 mg once daily) or placebo..
..The primary end point occurred in 5.5% of the patients in the colchicine group, as compared with 7.1% of those in the placebo group (hazard ratio, 0.77; 95% confidence interval [CI], 0.61 to 0.96; P=0.02). The hazard ratios were 0.84 (95% CI, 0.46 to 1.52) for death from cardiovascular causes, 0.83 (95% CI, 0.25 to 2.73) for resuscitated cardiac arrest, 0.91 (95% CI, 0.68 to 1.21) for myocardial infarction, 0.26 (95% CI, 0.10 to 0.70) for stroke, and 0.50 (95% CI, 0.31 to 0.81) for urgent hospitalization for angina leading to coronary revascularization. Diarrhea was reported in 9.7% of the patients in the colchicine group and in 8.9% of those in the placebo group (P=0.35). Pneumonia was reported as a serious adverse event in 0.9% of the patients in the colchicine group and in 0.4% of those in the placebo group (P=0.03).
CONCLUSIONS
Among patients with a recent myocardial infarction, colchicine at a dose of 0.5 mg daily led to a significantly lower risk of ischemic cardiovascular events than placebo
https://bit.ly/35Z6plV
New England Journal of Medicine
Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction | NEJM
Original Article from The New England Journal of Medicine — Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction
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Abdominal #obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial #infarction
..Univariate and multivariable-adjusted Cox regression models were used to calculate hazard ratios and 95% confidence intervals in quintiles of waist circumference as well as three categories of body mass index including normal weight, overweight and obesity.
Results
The majority of patients had abdominal obesity. During a median follow-up time of 3.8 years, 1232 men (7.3%) and 469 women (7.9%) experienced a recurrent atherosclerotic cardiovascular disease event. In the univariate analysis, risk was elevated in the fifth quintile (hazard ratio 1.22, 95% confidence interval 1.07–1.39) compared with the first. In the multivariable-adjusted analysis, risk was elevated in the fourth and fifth quintiles (hazard ratio 1.21, confidence interval 1.03–1.43 and hazard ratio 1.25, confidence interval 1.04–1.50), respectively. Gender-stratified analyses showed similar associations in men, while U-shaped associations were observed in women and the body mass index analyses.
Conclusions
Abdominal obesity was common in post-myocardial infarction patients and larger waist circumference was independently associated with recurrent atherosclerotic cardiovascular disease, particularly in men. We recommend utilising waist circumference to identify patients at increased risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction.
https://bit.ly/2vkx13c
Abdominal #obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial #infarction
..Univariate and multivariable-adjusted Cox regression models were used to calculate hazard ratios and 95% confidence intervals in quintiles of waist circumference as well as three categories of body mass index including normal weight, overweight and obesity.
Results
The majority of patients had abdominal obesity. During a median follow-up time of 3.8 years, 1232 men (7.3%) and 469 women (7.9%) experienced a recurrent atherosclerotic cardiovascular disease event. In the univariate analysis, risk was elevated in the fifth quintile (hazard ratio 1.22, 95% confidence interval 1.07–1.39) compared with the first. In the multivariable-adjusted analysis, risk was elevated in the fourth and fifth quintiles (hazard ratio 1.21, confidence interval 1.03–1.43 and hazard ratio 1.25, confidence interval 1.04–1.50), respectively. Gender-stratified analyses showed similar associations in men, while U-shaped associations were observed in women and the body mass index analyses.
Conclusions
Abdominal obesity was common in post-myocardial infarction patients and larger waist circumference was independently associated with recurrent atherosclerotic cardiovascular disease, particularly in men. We recommend utilising waist circumference to identify patients at increased risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction.
https://bit.ly/2vkx13c
SAGE Journals
Abdominal obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction - Hanieh Mohammadi…
Background The association between abdominal obesity and recurrent atherosclerotic cardiovascular disease after myocardial infarction remains unknown. Objective...
Effect of Smartphone-Enabled #Health Monitoring Devices vs Regular Follow-up on Blood Pressure Control Among Patients After Myocardial #Infarction
https://2medical.news/2020/04/22/effect-of-smartphone-enabled-health-monitoring-devices-vs-regular-follow-up-on-blood-pressure-control-among-patients-after-myocardial-infarction/
..For patients randomized to regular care, 4 physical outpatient clinic visits were scheduled in the year following the initial event. In the intervention group, patients were given 4 smartphone-compatible devices (weight scale, BP monitor, rhythm monitor, and step counter). In addition, 2 in-person outpatient clinic visits were replaced by electronic visits ..In total, 200 patients (median age, 59.7 years [interquartile range, 52.9-65.6 years]; 156 men …
https://2medical.news/2020/04/22/effect-of-smartphone-enabled-health-monitoring-devices-vs-regular-follow-up-on-blood-pressure-control-among-patients-after-myocardial-infarction/
..For patients randomized to regular care, 4 physical outpatient clinic visits were scheduled in the year following the initial event. In the intervention group, patients were given 4 smartphone-compatible devices (weight scale, BP monitor, rhythm monitor, and step counter). In addition, 2 in-person outpatient clinic visits were replaced by electronic visits ..In total, 200 patients (median age, 59.7 years [interquartile range, 52.9-65.6 years]; 156 men …
Blood #Pressure at 6 Months after Acute Myocardial #Infarction and Outcomes at 2 Years: The Perils Associated With Excessively Low Blood Pressures
https://2medical.news/2020/05/19/blood-pressure-at-6-months-after-acute-myocardial-infarction-and-outcomes-at-2-years-the-perils-associated-with-excessively-low-blood-pressures/
This study aimed to determine the association between achieved blood pressure at 6-month follow-up and cardiovascular outcomes at 2 years in patients treated with β-blockers and renin-angiotensin-aldosterone blockers after acute myocardial infarction (AMI).. ..Achieved blood pressures were categorized into 10-mm Hg increments. The primary outcome was all-cause death. The secondary outcome was a composite of all-cause death, MrI, and rHHF. Hazard ratios (HRs) were estimated …
https://2medical.news/2020/05/19/blood-pressure-at-6-months-after-acute-myocardial-infarction-and-outcomes-at-2-years-the-perils-associated-with-excessively-low-blood-pressures/
This study aimed to determine the association between achieved blood pressure at 6-month follow-up and cardiovascular outcomes at 2 years in patients treated with β-blockers and renin-angiotensin-aldosterone blockers after acute myocardial infarction (AMI).. ..Achieved blood pressures were categorized into 10-mm Hg increments. The primary outcome was all-cause death. The secondary outcome was a composite of all-cause death, MrI, and rHHF. Hazard ratios (HRs) were estimated …
Clinical Outcomes With #Beta-Blocker Use in Patients With Recent History of Myocardial #Infarction
https://2medical.news/2020/05/24/clinical-outcomes-with-beta-blocker-use-in-patients-with-recent-history-of-myocardial-infarction/
It is uncertain whether beta-blockers (BBs) are beneficial in contemporary stable patients with prior myocardial infarction (MI). Therefore, we sought to examine the effectiveness of BB use in this population.. ..We included 33,811 patients with prior MI, of whom 21,440 (63.4%) were dispensed a BB. The median age was 78 years, and 56% were male. There was no difference in the 1-year hazard of death/hospitalization …
https://2medical.news/2020/05/24/clinical-outcomes-with-beta-blocker-use-in-patients-with-recent-history-of-myocardial-infarction/
It is uncertain whether beta-blockers (BBs) are beneficial in contemporary stable patients with prior myocardial infarction (MI). Therefore, we sought to examine the effectiveness of BB use in this population.. ..We included 33,811 patients with prior MI, of whom 21,440 (63.4%) were dispensed a BB. The median age was 78 years, and 56% were male. There was no difference in the 1-year hazard of death/hospitalization …
Association of acute myocardial #infarction with #influenza: A nationwide observational study
https://2medical.news/2020/08/16/association-of-acute-myocardial-infarction-with-influenza-a-nationwide-observational-study/
Influenza may precipitate cardiovascular disease, but influenza typically peaks in winter, coinciding with other triggers of myocardial infarction (MI) such as low air temperature, high wind velocity, low atmospheric pressure, and short sunshine duration.. Weekly laboratory-confirmed influenza case reports were obtained from the Public Health Agency of Sweden from 2009 to 2016 and merged with the nationwide SWEDEHEART MI registry. Weekly incidence of MI was …
https://2medical.news/2020/08/16/association-of-acute-myocardial-infarction-with-influenza-a-nationwide-observational-study/
Influenza may precipitate cardiovascular disease, but influenza typically peaks in winter, coinciding with other triggers of myocardial infarction (MI) such as low air temperature, high wind velocity, low atmospheric pressure, and short sunshine duration.. Weekly laboratory-confirmed influenza case reports were obtained from the Public Health Agency of Sweden from 2009 to 2016 and merged with the nationwide SWEDEHEART MI registry. Weekly incidence of MI was …
Elevated #LDL cholesterol and increased risk of myocardial #infarction and #atherosclerotic cardiovascular disease in individuals aged 70–100 years: a contemporary primary prevention cohort
https://2medical.news/2020/11/13/elevated-ldl-cholesterol-and-increased-risk-of-myocardial-infarction-and-atherosclerotic-cardiovascular-disease-in-individuals-aged-70-100-years-a-contemporary-primary-prevention-cohort/
Findings of historical studies suggest that elevated LDL cholesterol is not associated with increased risk of myocardial infarction and atherosclerotic cardiovascular disease in patients older than 70 years. We aimed to test this hypothesis in a contemporary population of individuals aged 70–100 years.. ..Between Nov 25, 2003, and Feb 17, 2015, 91 131 individuals were enrolled in CGPS. During mean 7·7 (SD 3·2) years of follow-up …
https://2medical.news/2020/11/13/elevated-ldl-cholesterol-and-increased-risk-of-myocardial-infarction-and-atherosclerotic-cardiovascular-disease-in-individuals-aged-70-100-years-a-contemporary-primary-prevention-cohort/
Findings of historical studies suggest that elevated LDL cholesterol is not associated with increased risk of myocardial infarction and atherosclerotic cardiovascular disease in patients older than 70 years. We aimed to test this hypothesis in a contemporary population of individuals aged 70–100 years.. ..Between Nov 25, 2003, and Feb 17, 2015, 91 131 individuals were enrolled in CGPS. During mean 7·7 (SD 3·2) years of follow-up …
Association of Baseline and Longitudinal Changes in Body Composition Measures With Risk of #Heart Failure and Myocardial #Infarction in Type 2 #Diabetes: Findings From the Look AHEAD Trial
https://2medical.news/2020/11/17/association-of-baseline-and-longitudinal-changes-in-body-composition-measures-with-risk-of-heart-failure-and-myocardial-infarction-in-type-2-diabetes-findings-from-the-look-ahead-trial/
https://bit.ly/2Uqsd5F
https://2medical.news/2020/11/17/association-of-baseline-and-longitudinal-changes-in-body-composition-measures-with-risk-of-heart-failure-and-myocardial-infarction-in-type-2-diabetes-findings-from-the-look-ahead-trial/
https://bit.ly/2Uqsd5F
Long-term risk of #stroke and myocardial #infarction in middle-aged men with a #hypertensive response to exercise: a 44-year follow-up study
https://2medical.news/2021/02/14/long-term-risk-of-stroke-and-myocardial-infarction-in-middle-aged-men-with-a-hypertensive-response-to-exercise-a-44-year-follow-up-study/
Data on the prognostic value of hypertensive response to exercise in cardiovascular disease are limited. The aim was to determine whether SBP reactions during exercise have any prognostic value in relation to the long-term risk of stroke and myocardial infarction (MI). Patients and methods: A representative cohort of men from Gothenburg, Sweden, born in 1913, who performed a maximum exercise test at age 54 years, …
https://2medical.news/2021/02/14/long-term-risk-of-stroke-and-myocardial-infarction-in-middle-aged-men-with-a-hypertensive-response-to-exercise-a-44-year-follow-up-study/
Data on the prognostic value of hypertensive response to exercise in cardiovascular disease are limited. The aim was to determine whether SBP reactions during exercise have any prognostic value in relation to the long-term risk of stroke and myocardial infarction (MI). Patients and methods: A representative cohort of men from Gothenburg, Sweden, born in 1913, who performed a maximum exercise test at age 54 years, …
Elastin-like recombinamers-based #hydrogel modulates post-ischemic remodeling in a non-transmural myocardial #infarction in sheep
https://2medical.news/2021/02/23/elastin-like-recombinamers-based-hydrogel-modulates-post-ischemic-remodeling-in-a-non-transmural-myocardial-infarction-in-sheep/
Ischemic heart disease is a leading cause of mortality due to irreversible damage to cardiac muscle. Inspired by the post-ischemic microenvironment, we devised an extracellular matrix (ECM)–mimicking hydrogel using catalyst-free click chemistry covalent bonding between two elastin-like recombinamers (ELRs). The resulting customized hydrogel included functional domains for cell adhesion and protease cleavage sites, sensitive to cleavage by matrix metalloproteases overexpressed after myocardial infarction (MI). The …
https://2medical.news/2021/02/23/elastin-like-recombinamers-based-hydrogel-modulates-post-ischemic-remodeling-in-a-non-transmural-myocardial-infarction-in-sheep/
Ischemic heart disease is a leading cause of mortality due to irreversible damage to cardiac muscle. Inspired by the post-ischemic microenvironment, we devised an extracellular matrix (ECM)–mimicking hydrogel using catalyst-free click chemistry covalent bonding between two elastin-like recombinamers (ELRs). The resulting customized hydrogel included functional domains for cell adhesion and protease cleavage sites, sensitive to cleavage by matrix metalloproteases overexpressed after myocardial infarction (MI). The …
The Relationship Between Body #Mass Index and In-Hospital #Mortality in the Contemporary Era of an Acute Myocardial #Infarction Management
https://2medical.news/2021/09/12/the-relationship-between-body-mass-index-and-in-hospital-mortality-in-the-contemporary-era-of-an-acute-myocardial-infarction-management/
https://2medical.news/2021/09/12/the-relationship-between-body-mass-index-and-in-hospital-mortality-in-the-contemporary-era-of-an-acute-myocardial-infarction-management/
2Medical.News
The Relationship Between Body #Mass Index and In-Hospital #Mortality in the Contemporary Era of an Acute Myocardial #Infarction…
The association between body mass index (BMI) and clinical outcomes following an acute myocardial infarction (AMI) remains controversial. Our objective was to investigate the relationship between B…
#Beta-Blockers after Myocardial #Infarction and Preserved #Ejection Fraction
https://2medical.news/2024/04/16/beta-blockers-after-myocardial-infarction-and-preserved-ejection-fraction/
https://2medical.news/2024/04/16/beta-blockers-after-myocardial-infarction-and-preserved-ejection-fraction/
2Medical.News
#Beta-Blockers after Myocardial #Infarction and Preserved #Ejection Fraction
BACKGROUNDMost trials that have shown a benefit of beta-blocker treatment after myocardial infarction included patients with large myocardial infarctions and were conducted in an era before modern …