Nonfatal Acute Myocardial Infarction in Costa Rica

Kabagambe, Edmond K.; Baylin, Ana; Campos, Hannia

doi:10.1161/circulationaha.106.643544

Cited by 39 publications

(15 citation statements)

References 35 publications

(44 reference statements)

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“…In this population of Hispanic/Latino adults living in Costa Rica, we found that poor predictive lifestyle behaviors were associated with higher odds of MI, in line with previous studies 7, 9, 11, 36, 37, 38. The association for the GRS and higher odds of MI was consistent with previous literature analyzing SNPs in the chromosome 9p21 and higher risk of CHD and mortality 6, 10, 12.…”

Section: Discussionsupporting

confidence: 92%

“…A similar gradient of population‐attributable risk of only lifestyle factors was shown in a case–control study (15 152 cases and 14 820 controls) of acute MI in 52 countries, where the strongest risk factors for MI were smoking (population‐attributable risk=36%), abdominal obesity (20.1%), daily fruit and vegetables (13.7%), physical activity (12.2%), and regular alcohol consumption (7.1%) 37. In line with these results, strong evidence support that the modification of lifestyle factors could potentially decrease the risk of CHD, MI, stroke, and related clinical risk factors7, 9, 11, 36, 42, 43 even in secondary prevention 38…”

Section: Discussionmentioning

confidence: 58%

“…All participants gave informed consent on documents approved by the Human Subjects Committee of the Harvard T. H. Chan School of Public Health and the University of Costa Rica. Detailed description of the study methods was published previously 7, 24, 25…”

Section: Methodsmentioning

confidence: 99%

“…Briefly, the LCRS was calculated by using the estimated coefficients derived from the conditional regression model with MI as outcome and the lifestyle components as predictors, as weights for each of the 6 lifestyle components. The LCRS components (diet, physical activity, smoking, alcohol intake, waist:hip ratio, and socioeconomic status) were selected based on a prior analysis of modifiable MI risk factors in our study population as well as World Health Organization guidelines for healthy lifestyle (nutrition and physical activity) 7, 31, 32. The final LCRS was the sum of each component multiplied by the aforementioned regression coefficient.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to lifestyle, compelling evidence indicates that genetic susceptibility alone is part of the etiology of CHD and heart‐related events 6, 7, 8, 9, 10, 11. Genome‐wide association studies have identified chromosomal regions and genetic variants associated with CHD 6, 10, 12.…”

Section: Introductionmentioning

confidence: 99%

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Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica

Sotos‐Prieto

Baylin

Campos

et al. 2016

JAHA

Self Cite

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BackgroundA lifestyle cardiovascular risk score (LCRS) and a genetic risk score (GRS) have been independently associated with myocardial infarction (MI) in Hispanics/Latinos. Interaction or joint association between these scores has not been examined. Thus, our aim was to assess interactive and joint associations between LCRS and GRS, and each individual lifestyle risk factor, on likelihood of MI.Methods and ResultsData included 1534 Costa Rican adults with nonfatal acute MI and 1534 matched controls. The LCRS used estimated coefficients as weights for each factor: unhealthy diet, physical inactivity, smoking, elevated waist:hip ratio, low/high alcohol intake, low socioeconomic status. The GRS included 14 MI‐associated risk alleles. Conditional logistic regressions were used to calculate adjusted odds ratios. The odds ratios for MI were 2.72 (2.33, 3.17) per LCRS unit and 1.13 (95% CI 1.06, 1.21) per GRS unit. A significant joint association for highest GRS tertile and highest LCRS tertile and odds of MI was detected (odds ratio=5.43 [3.71, 7.94]; P<1.00×10−7), compared to both lowest tertiles. The odds ratios were 1.74 (1.22, 2.49) under optimal lifestyle and unfavorable genetic profile, and 5.02 (3.46, 7.29) under unhealthy lifestyle but advantageous genetic profile. Significant joint associations were observed for the highest GRS tertile and the highest of each lifestyle component risk category. The interaction term was nonsignificant (P=0.33).ConclusionsLifestyle risk factors and genetics are jointly associated with higher odds of MI among Hispanics/Latinos. Individual and combined lifestyle risk factors showed stronger associations. Efforts to improve lifestyle behaviors could help prevent MI regardless of genetic susceptibility.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica

Sotos‐Prieto

Baylin

Campos

et al. 2016

JAHA

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Risk Factors, Therapeutic Approaches, and In‐Hospital Outcomes in Mexicans With ST‐Elevation Acute Myocardial Infarction: The RENASICA II Multicenter Registry

Juarez-Herrera¹,

Jerjes‐Sánchez²,

Investigators³

2013

Clinical Cardiology

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Background: Ischemic heart disease is a growing health problem in Latin America. We aimed to analyze risk factors, acute management, and short-term outcome of Mexicans with ST-elevation myocardial infarction (STEMI). Hypothesis: Modifiable risk factors are associated with the occurrence of STEMI in Mexicans, and potentially preventable acute complications are responsible for most short-term deaths. Methods: Among 8600 patients enrolled in Registro Nacional de los Síndromes Coronarios Agudos II (RENASICA II) with a suspected acute coronary syndrome, we analyzed 4555 patients (56%; age 21-100 y) with confirmed STEMI who presented within 24 hours from symptoms' onset. Results: Smoking (66%), hypertension (50%), and diabetes (43%) were the main risk factors. Most patients (74%) presented with Killip class I (class IV in 4%). Anterior-located STEMI occurred in 56% of cases, and posterior-inferior in 40% of cases. Significant Q waves were present in 43%, right bundle branch block in 7%, left bundle branch block in 5%, first-degree atrioventricular block in 2%, and high-degree atrioventricular block in 2%. A total of 1685 (37%) patients received fibrinolytic therapy (streptokinase, 82%; alteplase, 17%; tenecteplase, 1%), with 31% of patients receiving therapy in <2 hours, 36% in 2-4 hours, 19% in 4-6 hours, and 15% in >6 hours. Thirty percent of patients received either percutaneous coronary intervention or coronary artery bypass grafting during hospitalization. Major adverse cardiovascular events were recurrent ischemia (12%), reinfarction (4%), cardiogenic shock (4%), and stroke (1%). The main predictors of 30-day mortality (10%) in multivariate analysis were age ≥65 years (odds ratio [OR]

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The Cardiovascular Effects of Methylxanthines

2010

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In the concentration range that is normally achieved in humans, e.g., after the drinking of coffee or in patients treated with theophylline, the cardiovascular effects of methylxanthines are primarily due to antagonism of adenosine A(1) and A(2) receptors. Inhibition of phosphodiesterases or mobilization of intracellular calcium requires much higher concentrations. In conscious humans, acute exposure to caffeine results in an increase in blood pressure by an increased total peripheral resistance, and a slight decrease in heart rate. This overall hemodynamic response is composed of direct effects of caffeine on vascular tone, on myocardial contractility and conduction, and on the sympathetic nervous system. Caffeine is the most widely consumed methylxanthine, mainly derived from coffee intake. Regular coffee consumption can affect various traditional cardiovascular risk factors, including a slight increase in blood pressure, an increase in plasma cholesterol and homocysteine levels, and a reduced incidence of type 2 diabetes mellitus. Although most prospective studies have not reported an association between coffee consumption and coronary heart disease, these findings do not exclude that the acute hemodynamic and neurohumoral effects of coffee consumption could have an adverse effect in selected patient groups who are more vulnerable for these effects, based on their genetic profile or medication use.

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Nonfatal Acute Myocardial Infarction in Costa Rica

Cited by 39 publications

References 35 publications

Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica

Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica

Risk Factors, Therapeutic Approaches, and In‐Hospital Outcomes in Mexicans With ST‐Elevation Acute Myocardial Infarction: The RENASICA II Multicenter Registry

The Cardiovascular Effects of Methylxanthines

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