Prognosis after the onset of coronary heart disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation.

Murabito, Joanne M.; Evans, Jane C.; Larson, Martin G.; Levy, Daniel

doi:10.1161/01.cir.88.6.2548

Cited by 168 publications

(87 citation statements)

References 31 publications

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“…EKG abnormalities that can be mistaken for MI but are not caused by coronary disease are more often seen in women than in men, possibly caused by difficulties in correctly placing the electrodes due to breast tissue. 32 Because of this possible nondifferential misclassification of our determinant, dilution of the effect might have occurred and therefore the true effect may have been missed in women in our data set. Such misclassification might also explain the higher prevalence of unrecognized MI among women than men.…”

Section: Discussionmentioning

confidence: 95%

Unrecognized Myocardial Infarction in Relation to Risk of Dementia and Cerebral Small Vessel Disease

Ikram

Oijen

Jong

et al. 2008

Stroke

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Background and Purpose-Men, but not women, with unrecognized myocardial infarction (MI) have an increased risk of cardiac events and stroke compared with those without MI or with recognized MI. We investigated whether unrecognized MI is also a risk factor for dementia and cerebral small vessel disease (white matter lesions and brain infarction) in 2 population-based cohort studies. Methods-In the Rotterdam Study, 6347 participants were classified at baseline (1990 to 1993) into those with recognized MI (subdivided into Q-wave and non-Q-wave MI), with unrecognized MI, and without MI based on electrocardiography and interview and were followed for incident dementia (nϭ613) until January 1, 2005. In the Rotterdam Scan Study, 436 nondemented persons were similarly classified based on electrocardiography and interview and underwent brain MRI for the assessment of white matter lesions and brain infarction. Results-In men, unrecognized MI was associated with an increased risk of dementia (compared with men without MI hazard ratio, 2.14; 95% CI, 1.37 to 3.35) and with more white matter lesions and more often brain infarction on MRI.In women, no associations were found with unrecognized MI. Recognized MI was not associated with the risk of dementia in either sex. Men, but not women, with recognized MI had more often any brain infarction or asymptomatic brain infarction, especially if they had Q-wave MI. No consistent associations were found between recognized Q-wave or non-Q-wave MI and severity of white matter lesions. Additional adjustment for cardiovascular risk factors did not change the results. Conclusions-Men with unrecognized MI have an increased risk of dementia and more cerebral small vessel disease.

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Section: Discussionmentioning

confidence: 95%

Unrecognized Myocardial Infarction in Relation to Risk of Dementia and Cerebral Small Vessel Disease

Ikram

Oijen

Jong

et al. 2008

Stroke

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“…The risk for heart disease or subclinical or clinical disease exists even as patients enter dialysis treatment. In the United States Renal Data System (USRDS) Wave 2 study, for example, the prevalence of ischemic heart disease and cardiac failure was approximately 40% before renal replacement, much higher than the 2 to 26% reported in the general population (3). In a Canadian study, baseline echocardiography identified 74% of patients entering first-time dialysis treatment with left ventricular (LV) hypertrophy (4).…”

Section: Epidemiologymentioning

confidence: 99%

Impact of Dyslipidemia in End-Stage Renal Disease

Prichard

2003

Journal of the American Society of Nephrology

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Abstract. Heart disease is a major cause of morbidity and mortality among patients with renal failure. Premature atherosclerotic coronary heart disease is driven by multiple risk factors, including dyslipidemia and oxidative stress. In the nondialysis population, there is overwhelming evidence that treatment of dyslipidemia can significantly improve cardiovascular outcomes. Accumulating data indicate that dialysis patients have atherogenic lipid abnormalities. Although LDL cholesterol (LDL-C) levels in patients who undergo hemodialysis are normal or near normal, increased oxidized LDL-C, triglycerides, and lipoprotein (a) [Lp(a)]; decreased HDL cholesterol (HDL-C); and triglyceride-rich VLDL have been noted. Patients who receive peritoneal dialysis have a more atherogenic lipid profile with increased LDL-C, apolipoprotein B, oxidized LDL-C, triglycerides, and Lp(a) and decreased HDL-C. Furthermore, the LDL particles of peritoneal dialysis patients are small and dense. However, there is a dearth of information regarding the goals, efficacy, and safety of dyslipidemia treatment among dialysis patients. Given the strong evidence of risk reduction and the benefits of lipid-lowering treatment in the nondialysis population, the emerging consensus is that dialysis patients should be treated aggressively for dyslipidemia to an LDL-C goal below 100 mg/dl. Although physicians and patients may be reluctant to add medications because of concerns about polypharmacy, potential decreased compliance, and increased cost, the use of agents such as sevelamer that can serve multiple functions, including phosphate control, lipid lowering (decreased LDL-C and total cholesterol), and anti-inflammatory effects (decreased high-sensitivity C-reactive protein), should be explored and considered for patients who would benefit from such treatment.

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“…Stable angina or chest pain is commonly the initial presentation of coronary disease, particularly in women (33) and may precede myocardial infarction by years. Diagnosis is notoriously difficult, and increasingly it is observed that there is an appreciable risk of subsequent coronary events(34) among patients with "non-cardiac" chest pain (35), nonobstructed angiograms(36) and admissions with "chest pain" without further diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of angina pectoris: Role of natural language processing of the medical record

Pakhomov

Hemingway²,

Weston

et al. 2007

American Heart Journal

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Prognosis after the onset of coronary heart disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation.

Cited by 168 publications

References 31 publications

Unrecognized Myocardial Infarction in Relation to Risk of Dementia and Cerebral Small Vessel Disease

Unrecognized Myocardial Infarction in Relation to Risk of Dementia and Cerebral Small Vessel Disease

Impact of Dyslipidemia in End-Stage Renal Disease

Epidemiology of angina pectoris: Role of natural language processing of the medical record

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