TY - JOUR
T1 - Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction
AU - Canto, John G.
AU - Kiefe, Catarina I.
AU - Rogers, William J.
AU - Peterson, Eric D.
AU - Frederick, Paul D.
AU - French, William J.
AU - Gibson, C. Michael
AU - Pollack, Charles V.
AU - Ornato, Joseph P.
AU - Zalenski, Robert J.
AU - Penney, Jan
AU - Tiefenbrunn, Alan J.
AU - Greenland, Philip
PY - 2011/11/16
Y1 - 2011/11/16
N2 - 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 ≲λτ∀.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.
AB - 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 ≲λτ∀.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.
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U2 - 10.1001/jama.2011.1654
DO - 10.1001/jama.2011.1654
M3 - Article
C2 - 22089719
AN - SCOPUS:81255147429
SN - 0098-7484
VL - 306
SP - 2120
EP - 2127
JO - JAMA
JF - JAMA
IS - 19
ER -
