Number of Coronary Heart Disease Risk Factors and Mortality in Patients With First Myocardial Infarction

被引：197

作者：

Canto, John G. ^{[1
]}

Kiefe, Catarina I. ^{[2
]}

Rogers, William J. ^{[3
]}

Peterson, Eric D. ^{[4
]}

Frederick, Paul D. ^{[5
]}

French, William J. ^{[6
]}

Gibson, C. Michael ^{[7
]}

Pollack, Charles V., Jr. ^{[8
]}

Ornato, Joseph P. ^{[9
]}

Zalenski, Robert J. ^{[10
]}

Penney, Jan ^{[11
]}

Tiefenbrunn, Alan J. ^{[12
]}

Greenland, Philip ^{[13
]}

机构：

[1] Watson Clin LLP, Ctr Cardiovasc Prevent Res & Educ, Lakeland, FL USA

[2] Univ Massachusetts, Sch Med, Worcester, MA USA

[3] Univ Alabama Birmingham, Med Ctr, Birmingham, AL 35294 USA

[4] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA

[5] ICON Late Phase & Outcomes Res, San Francisco, CA USA

[6] Harbor UCLA Med Ctr, Torrance, CA 90509 USA

[7] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Boston, MA 02215 USA

[8] Univ Penn, Philadelphia, PA 19104 USA

[9] Virginia Commonwealth Univ, Richmond, VA 23284 USA

[10] Wayne State Univ, Sch Med, Detroit, MI USA

[11] Mid Michigan Hlth, Midland, MI USA

[12] Washington Univ, Sch Med, St Louis, MO USA

[13] Northwestern Univ, Clin & Translat Sci Inst, Chicago, IL 60611 USA

来源：

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2011年 / 306卷 / 19期

基金：

美国国家卫生研究院;

关键词：

NATIONAL REGISTRY; EVENTS; INDEX;

D O I：

10.1001/jama.2011.1654

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context Few studies have examined the association between the number of coronary heart disease risk factors and outcomes of acute myocardial infarction in community practice. Objective To determine the association between the number of coronary heart disease risk factors in patients with first myocardial infarction and hospital mortality. Design Observational study from the National Registry of Myocardial Infarction, 1994-2006. Patients We examined the presence and absence of 5 major traditional coronary heart disease risk factors (hypertension, smoking, dyslipidemia, diabetes, and family history of coronary heart disease) and hospital mortality among 542 008 patients with first myocardial infarction and without prior cardiovascular disease. Main Outcome Measure All-cause in-hospital mortality. Results A majority (85.6%) of patients who presented with initial myocardial infarction had at least 1 of the 5 coronary heart disease risk factors, and 14.4% had none of the 5 risk factors. Age varied inversely with the number of coronary heart disease risk factors, from a mean age of 71.5 years with 0 risk factors to 56.7 years with 5 risk factors (P for trend < .001). The total number of in-hospital deaths for all causes was 50 788. Unadjusted in-hospital mortality rates were 14.9%, 10.9%, 7.9%, 5.3%, 4.2%, and 3.6% for patients with 0, 1, 2, 3, 4, and 5 risk factors, respectively. After adjusting for age and other clinical factors, there was an inverse association between the number of coronary heart disease risk factors and hospital mortality adjusted odds ratio (1.54; 95% CI, 1.23-1.94) among individuals with 0 vs 5 risk factors. This association was consistent among several age strata and important patient subgroups. Conclusion Among patients with incident acute myocardial infarction without prior cardiovascular disease, in-hospital mortality was inversely related to the number of coronary heart disease risk factors. JAMA. 2011;306(19):2120-2127 www.jama.com

引用

页码：2120 / 2127

页数：8

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