41‐Month Follow‐Up of Risk Factors Correlated With New Coronary Events in 708 Elderly Patients

Aronow, Wilbert S.; Herzig, Abbe; Etienne, Fritzner; D'Alba, Peter; Ronquillo, Jocelyn

doi:10.1111/j.1532-5415.1989.tb05679.x

Cited by 61 publications

(25 citation statements)

References 24 publications

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“…Serum triglyceride and HDL-C concentrations did not correlate with re-infarction in this study. Although some investigations have shown that the serum TC has a predictive value for re-infarction in elderly persons with coronary heart disease, 19 others have observed that serum cholesterol levels determined after MI did not have prognostic value. 20,21 Finding that the cholesterol measurements done during the acute phase after infarction have predictive value creates a problem, because cholesterol concentrations may actually fall spontaneously during this period.…”

Section: Discussionmentioning

confidence: 96%

Risk Factors Indicating Recurrent Myocardial Infarction After Recovery From Acute Myocardial Infarction.

Saito

Shiraki

Oka

et al. 2002

Circ J

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yocardial infarction (MI) is now one of the most frequent causes of death in elderly subjects in Japan; in 1999 approximately 15,000 cardiac deaths occurred in Japan and the majority was related to myocardial infarction (MI). 1 Furthermore, among survivors of an acute MI (AMI), the incidence of a subsequent MI is increased 3-to 6-fold, and the risk of any cardiovascular event is as high as 80%. 2 Because patients with a previous history of cardiovascular events are at high risk for a future MI, 3 aggressive management, including risk factor modification, is mandatory in this patient group. [4][5][6] Considerable evidence indicates that a secondary prevention program to reduce cardiovascular risk factors can favorably affect cardiovascular mortality and morbidity. 7,8 Although there are many available studies from North America and Europe regarding the risk factors for recurrent MI after the recovery from AMI, 9-11 little is known concerning the Japanese population. 12 Racial differences, including genetic factors, life style, and the environmental circumstances of the patients, will affect the factors that accelerate coronary atherosclerosis and advance to subsequent MI, so we evaluated the risk factors of a recurrent MI in Japanese patients after recovery from the first AMI. Methods Study PatientsThe study group consisted of patients experiencing their first episode of AMI who were admitted to Iwakuni National Hospital from January 1, 1991 to December 31, Circulation Journal Vol.66, October 20022000 within 48 h of developing chest pain and who were discharged after recovery.The diagnosis of AMI was established by the presence of 2 of the following 3 criteria: (1) elevation of serum creatine kinase (CK) more than triple the upper normal limit, (2) characteristic chest pain, or (3) ECG findings of ST-T change with evolution of the Q wave. Non-Q wave infarction was diagnosed by typical ST segment and/or T wave changes associated with serum CK elevation.All patients were in New York Heart Association functional class I or II at discharge. The patients were followed up at the hospital or by mail at 6 and 12 months, and 5 and 10 years after discharge, and follow-up data was available from more than 90% of patients at 1 year post discharge. Patients who died from an unknown cause were excluded. Because most of the patients who had a second MI were admitted to Iwakuni National Hospital, there was no apparent difficulty in obtaining information regarding the second cardiac event.Risk factors identified from the medical history, physical findings, laboratory data, ECG and chest X-ray were reviewed. The standard 12-lead ECG was recorded on admission, 3 h later and then once a day for 4 days. The ECG in leads CM5 and NASA was continuously monitored for at least 48 h after admission. The location of the infarction was divided into 2 groups based on involvement of the left ventricular anterior wall: (1) anterior and (2) other. Serum low-density lipoprotein-cholesterol (LDL-C) concentration was calculated from the values of t...

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Section: Discussionmentioning

confidence: 96%

Risk Factors Indicating Recurrent Myocardial Infarction After Recovery From Acute Myocardial Infarction.

Saito

Shiraki

Oka

et al. 2002

Circ J

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“…HT has been shown to be an independent risk factor for CAD, [54][55][56] but systolic HT had not been suggested as an important CAD risk factor in the elderly. 57 In 1991, however, the Systolic Hypertension in the Elderly Program (SHEP) trial demonstrated that treating systolic HT in those aged over 60 years reduced nonfatal myocardial infarction by 33% over a 4.5-year follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Role of Hypertension, Dyslipidemia and Diabetes Mellitus in the Development of Coronary Atherosclerosis in Japan

et al. 2001

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“…Five studies were excluded from the statistical analysis because of insufficient data (21)(22)(23)(24)(25). These studies did not calculate separate relative risks for the 2 sexes and did not provide enough data for them to be extracted.…”

Section: Discussionmentioning

confidence: 99%

“…RESULTS -Sixteen prospective cohort studies were eligible for this analysis (5,6,(8)(9)(10)13,18,(21)(22)(23)(24)(25)(26)(27)(28)(29); 5 studies, as described above, were excluded from further consideration because of missing data. Important characteristics of all of the studies are listed in Tables 1 and 2.…”

Section: Discussionmentioning

confidence: 99%

Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

et al. 2000

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A meta-analysis of prospective studies O R I G I N A L A R T I C L EOBJECTIVE -Women are at a much lower risk of coronary disease mortality than men are. It is widely believed that diabetes "erases" this female advantage, increasing the risk of heart disease much more in women than in men. In reality, the extent of this increased risk is controversial, with studies showing conflicting results and wide confidence intervals. Clarification of this issue has implications for the pathogenesis of coronary disease, and for public health efforts to reduce coronary disease in women.RESEARCH DESIGN AND METHODS -We performed a meta-analysis to calculate a summary estimate of the relative risk of coronary death among women with diabetes as compared to those without. For comparison, we also calculated the analogous risk among men. All prospective cohort studies containing both men and women, and both patients with and without diabetes, were examined. Sixteen studies were identified; 10 had sufficient data for statistical analysis.RESULTS -After combining studies that adjusted for other cardiac risk factors, the relative risk of coronary death from diabetes was 2.58 (95% CI 2.05-3.26) for women and 1.85 (1.47-2.33) for men. This difference is statistically significant (P = 0.045). Other sensitivity analyses did not change these estimates appreciably.CONCLUSIONS -The impact of diabetes on the risk of coronary death is significantly greater for women than men. Further research is required to explain this clinically meaningful difference between the sexes. Diabetes Care 23:962-968, 2000

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41‐Month Follow‐Up of Risk Factors Correlated With New Coronary Events in 708 Elderly Patients

Cited by 61 publications

References 24 publications

Risk Factors Indicating Recurrent Myocardial Infarction After Recovery From Acute Myocardial Infarction.

Risk Factors Indicating Recurrent Myocardial Infarction After Recovery From Acute Myocardial Infarction.

Role of Hypertension, Dyslipidemia and Diabetes Mellitus in the Development of Coronary Atherosclerosis in Japan

Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies.

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