Vitality and recurrent event risk in acute myocardial infarction survivors

2009 ◽  
Vol 16 (4) ◽  
pp. 499-505 ◽  
Author(s):  
Brent A. Williams ◽  
Joan M. Dorn ◽  
Richard P. Donahue ◽  
Kathleen M. Hovey ◽  
Lisa B. Rafalson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Disease Risk ◽  
Short Form ◽  
Cardiovascular Disease Risk ◽  
Cox Proportional Hazards ◽  
Recurrent Event ◽  
Cardiac Events ◽  
Increased Risk

Background Low vitality, characterized by fatigue and lack of energy, is common among survivors of acute myocardial infarction (AMI) and has been shown to be associated with increased risk of primary and secondary cardiac events. The goal of this study was to determine whether an association between vitality and recurrent cardiac events (nonfatal MI, cardiac death) among acute MI survivors persists after controlling for possible physiological and psychological confounders. Design and methods Incident AMI survivors ( n = 1328) from Erie and Niagara (New York) county hospitals were enrolled and followed up to 9 years. Vitality was measured by the Short Form-36 on a 0–100 scale approximately 4 months post-AMI. Cox proportional hazards models were developed to assess the vitality-recurrent event association controlling for traditional cardiovascular disease risk factors, index MI severity, and psychological correlates of vitality. Results Low-vitality individuals at baseline were more likely females, of higher BMI, smoking, diabetic, less physically active, and to have worse depression scores. Vitality was not strongly associated with MI severity markers. Lower vitality scores were associated with increased risk of recurrent cardiac events: adjusted hazard ratios (95% CI) for vitality scores 51–79, 21–50, and ≤ 20 (compared with ≥ 80) were 1.2 (0.8, 1.8), 1.4 (0.9, 2.2), and 2.9 (1.5, 5.4), respectively ( Ptrend = 0.005). Conclusion Low vitality was associated with increased risk of recurrent cardiac events among AMI survivors after controlling for physiological and psychological confounders. Mechanistic links with vitality should be sought as interventional targets.

Abstract 2612: Derived Fibrinogen Versus Brain Natriuretic Peptide and C-Reactive Protein as a Predictor of Events After Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Terry R Ketch ◽  
Samuel J Turner ◽  
Matthew T Sacrinty ◽  
Kevin C Lingle ◽  
Robert J Applegate ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stent Placement ◽  
Proportional Hazards ◽  
Thrombus Formation ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Cardiac Events ◽  
Coronary Events

Multiple biomarkers have been studied to assess risk for future coronary events. Fibrinogen is involved in platelet aggregation, thrombus formation, and is a marker of inflammation. Furthermore, prothrombin time-derived fibrinogen levels are widely available with routine coagulation assays. We retrospectively evaluated admission derived fibrinogen, BNP and CRP levels as well as baseline clinical and procedural characteristics of 475 consecutive patients admitted with acute myocardial infarction who subsequently underwent stent placement. Major adverse cardiac event (MACE) outcomes data were collected to two years after index admission. Higher quartiles of admission fibrinogen levels were associated with increased hazard of death from any cause (log-rank p-value <0.001), non-fatal myocardial infarction (log-rank p-value <0.001), and any MACE (log-rank p-value = 0.004) at two years. In a Cox proportional hazards multivariate model including the covariates age (10 years), heart failure class, smoking status, diabetes, hypertension, cerebrovascular disease, history of renal failure, previous PCI and/or CABG, multivessel coronary disease, BNP and CRP, increased admission derived fibrinogen remained a significant predictor of increased hazard of MACE at two years [HR 2.22 (1.03– 4.77)]. In the same model, BNP [HR 0.95 (0.82–1.08)] and CRP [HR 1.22 (1.01–1.47)] were less robust prognosticators. In patients admitted with an acute myocardial infarction who undergo PCI with stent placement, admission derived fibrinogen levels, a widely available analyte, are more strongly predictive of future major adverse cardiac events than BNP and CRP.

scholarly journals Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study

2010 ◽  
Vol 69 (6) ◽  
pp. 1162-1164 ◽  
Author(s):  
Mary A De Vera ◽  
M Mushfiqur Rahman ◽  
Vidula Bhole ◽  
Jacek A Kopec ◽  
Hyon K Choi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Elderly Women ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Prescription Drug Use ◽  
Increased Risk

BackgroundMen with gout have been found to have an increased risk of acute myocardial infarction (AMI), but no corresponding data are available among women.ObjectiveTo evaluate the potential independent association between gout and the risk of AMI among elderly women, aged ≥65 years.MethodsA population-based cohort study was conducted using the British Columbia Linked Health Database and compared incidence rates of AMI between 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease. Cox proportional hazards models stratified by gender were used to estimate the relative risk (RR) for AMI, adjusting for age, comorbidities and prescription drug use.ResultsOver a 7-year median follow-up, 3268 incident AMI cases, were identified, 996 among women. Compared with women without gout, the multivariate RRs among women with gout were 1.39 (95% CI 1.20 to 1.61) for all AMI and 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI. These RRs were significantly larger than those among men (multivariate RRs for all AMI and non-fatal AMI, 1.11 and 1.11; p values for interaction, 0.003 and 0.005, respectively).ConclusionThese population-based data suggest that women with gout have an increased risk for AMI and the magnitude of excess risk is higher than in men.

Abstract P380: Coronary Artery Disease Extent is Predictive of Heart Failure Incidence After Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yariv Gerber ◽  
Susan A Weston ◽  
Maurice E Sarano ◽  
Sheila M Manemann ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Disease Extent ◽  
Increased Risk ◽  
Artery Disease

Background: Little is known about the association between coronary artery disease (CAD) and the risk of heart failure (HF) after myocardial infarction (MI), and whether it differs by reduced (HFrEF) or preserved (HFpEF) ejection fraction (EF) has yet to be determined. Subjects and Methods: Olmsted County, Minnesota residents (n=1,924; mean age, 64 years; 66% male) with first MI diagnosed in 1990-2010 and no prior HF were followed through 2013. Framingham Heart Study criteria were used to define HF, which was further classified according to EF (applying a 50% cutoff). The extent of angiographic CAD was defined at index MI according to the number of major epicardial coronary arteries with ≥50% lumen diameter obstruction. Fine & Gray and Cox proportional hazards regression models were used to assess the association of CAD categories with incidence of HF, and multiple imputation methodology was applied to account for the 19% with missing EF data. Results: During a mean (SD) follow-up of 6.7 (5.9) years, 594 patients developed HF. Adjusted for age and sex, with death considered a competing risk, the cumulative incidence rates of HF among patients with 1- (n=581), 2- (n=622), and 3-vessel disease (n=721) were 11.2%, 14.6% and 20.5% at 30 days; and 18.1%, 22.3% and 29.4% at 5 years after MI, respectively. The increased risk of HF with greater number of occluded vessels was only modestly attenuated after further adjustment for patient and MI characteristics, and did not differ materially by EF (Table). Conclusions: The extent of angiographic CAD expressed by the number of diseased vessels is independently associated with HF incidence after MI. The association is evident promptly after MI and applies to both HFrEF and HFpEF.

scholarly journals Distinct eGFR trajectories are associated with risk of myocardial infarction in people with diabetes or pre-diabetes

2020 ◽  
Author(s):  
Yingting Zuo ◽  
Anxin Wang ◽  
Shuohua Chen ◽  
Xue Tian ◽  
Shouling Wu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Proportional Hazards ◽  
Exposure Period ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
And Control ◽  
Incident Cases

Abstract Background The relationship between estimated glomerular filtration rate (eGFR) trajectories and myocardial infarction (MI) remains unclear in people with diabetes or prediabetes. We aimed to identify common eGFR trajectories in people with diabetes or prediabetes and to examine their association with MI risk. Methods The data of this analysis was derived from the Kailuan study, which was a prospective community-based cohort study. The eGFR trajectories of 24,723 participants from year 2006 to 2012 were generated by latent mixture modeling. Incident cases of MI occurred during 2012 to 2017, confirmed by review of medical records. Cox proportional hazards models were used to calculate hazard ratios (HR) and their 95% confidence intervals (CIs) for the subsequent risk of MI of different eGFR trajectories. Results We identified 5 distinct eGFR trajectories, and named them as low-stable (9.4%), moderate-stable (31.4%), moderate-increasing (29.5%), high-decreasing (13.9%) and high-stable (15.8%) according to their range and pattern. During a mean follow-up of 4.61 years, there were a total of 235 incident MI. Although, the high-decreasing group had similar eGFR levels with the moderate-stable group at last exposure period, the risk was much higher (adjusted HR, 3.43; 95%CI, 1.56–7.54 versus adjusted HR, 2.82; 95%CI, 1.34–5.95). Notably, the moderate-increasing group had reached to the normal range, still had a significantly increased risk (adjusted HR, 2.55; 95%CI, 1.21–5.39). Conclusions eGFR trajectories were associated with MI risk in people with diabetes or prediabetes. Emphasis should be placed on early and long-term detection and control of eGFR decreases to further reduce MI risk.

scholarly journals Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database

2020 ◽  
Vol 26 ◽  
pp. 107602962095083
Author(s):  
Tang Zhang ◽  
Yao-Zong Guan ◽  
Hao Liu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Short Term ◽  
Hazards Model ◽  
Short Term Mortality ◽  
Mimic Iii

Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients ( P < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients ( P < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, P = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, P = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.

scholarly journals Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea

2020 ◽  
Vol 17 (8) ◽  
pp. 2841
Author(s):  
Seulggie Choi ◽  
Kyae Hyung Kim ◽  
Kyuwoong Kim ◽  
Jooyoung Chang ◽  
Sung Min Kim ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Particulate Matter ◽  
Cancer Survivors ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
Increased Risk ◽  
Yearly Average ◽  
Pm2.5 Exposure

Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5–10 (PM2.5–10) μm in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07–1.59). Conversely, increasing PM10 and PM2.5–10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.

Abstract 140: Association Between Epilepsy and the Risk of Ischemic Stroke or Myocardial Infarction

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Matthew A Mercuri ◽  
Alexander E Merkler ◽  
Neal S Parikh ◽  
Michael E Reznik ◽  
Hooman Kamel
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Proportional Hazards ◽  
Predictor Variable ◽  
Cox Proportional Hazards ◽  
Vascular Events ◽  
Increased Risk ◽  
Acute Mi

Background: Vascular brain injury can result in epilepsy. It is posited that seizures in elderly patients might reflect subclinical vascular disease and thus herald future clinical vascular events. Hypothesis: Seizures in elderly patients are associated with an increased risk of ischemic stroke or myocardial infarction (MI). Methods: We obtained inpatient and outpatient claims data from 2008-2014 on a 5% sample of Medicare beneficiaries ≥66 years of age. The predictor variable was epilepsy, defined as two or more inpatient or outpatient claims with a diagnosis of seizure. The primary outcome was a composite of ischemic stroke or acute MI. The predictors and outcomes were all ascertained with previously validated ICD-9-CM code algorithms. Survival statistics and Cox proportional hazards models were used to assess the relationship between epilepsy and incident ischemic stroke or MI while adjusting for demographic characteristics and vascular risk factors. Patients were censored at the first occurrence of a stroke or MI, at the time of death, or on December 31, 2014. Results: Among 1,548,556 beneficiaries with a mean follow-up of 4.4 (±1.8) years, 15,055 (1.0%) developed epilepsy and 121,866 (7.9%) experienced an ischemic stroke or acute MI. Patients with seizures were older (76.1 versus 73.7 years) and had a significantly higher burden of vascular comorbidities than the remainder of the cohort. The annual incidence of stroke or acute MI was 3.28% (95% confidence interval [CI], 3.10-3.47%) in those with seizures versus 1.79% (95% CI, 1.78-1.80%) in those without (unadjusted hazard ratio [HR], 1.89; 95% CI, 1.78-2.00). After adjustment for demographics and risk factors, epilepsy had a weak association with the composite outcome (adjusted HR, 1.36; 95% CI, 1.29-1.44), a stronger association with ischemic stroke (adjusted HR, 1.77; 95% CI, 1.65-1.90), and no association with acute MI (adjusted HR, 0.95; 95% CI, 0.86-1.04). Conclusions: We found an association between epilepsy in elderly patients and future ischemic stroke but not acute MI. Therefore, seizures might signify occult cerebrovascular disease but not necessarily occult disease in other vascular beds.

scholarly journals Prognostic Role of High Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Shanjie Wang ◽  
Shaohong Fang ◽  
Bo Yu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
High Sensitivity ◽  
Cox Proportional Hazards ◽  
Post Discharge ◽  
Reactive Protein ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Hs Crp

Background: High sensitivity CRP (hs-CRP) has attracted intense interest in risk assessment. We aimed to explore its prognostic value in patients with acute myocardial infarction (AMI).Methods and Results: We enrolled 4,504 consecutive AMI patients in this prospective cohort study. The associations between hs-CRP levels with the incidence of in-hospital HF was evaluated by logistic regression analysis. The association between hs-CRP levels and the cumulative incidence of HF after hospitalization were evaluated by Fine-Gray proportional sub-distribution hazards models, accounting for death without HF as competing risk. Cox proportional hazards regression models were constructed to estimate the association between hs-CRP levels and the risk of all-cause mortality. Over a median follow-up of 1 year, 1,112 (24.7%) patients developed in-hospital HF, 571 (18.9%) patients developed HF post-discharge and 262 (8.2%) patients died. In the fully adjusted model, the risk of in-hospital heart failure (HF) [95% confidence intervals (CI)] among those patients with hs-CRP values in quartile 3 (Q3) and Q4 were 1.36 (1.05–1.77) and 1.41 (1.07–1.85) times as high as the risk among patients in Q1 (p trend &lt; 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.33 (1.00–1.76) and 1.80 times (1.37–2.36) as high as the risk of HF post-discharge compared with patients in Q1 respectively (p trend &lt; 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.74 (1.08–2.82) and 2.42 times (1.52–3.87) as high as the risk of death compared with patients in Q1 respectively (p trend &lt; 0.001).Conclusions: Hs-CRP was found to be associated with the incidence of in-hospital HF, HF post-discharge and all-cause mortality in patients with AMI.

scholarly journals Objective Assessment of Daytime Napping and Incident Heart Failure in 1140 Community‐Dwelling Older Adults: A Prospective, Observational Cohort Study

2021 ◽  
Author(s):  
Peng Li ◽  
Arlen Gaba ◽  
Patricia M. Wong ◽  
Longchang Cui ◽  
Lei Yu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Proportional Hazards ◽  
Disease Risk ◽  
Objective Assessment ◽  
Cardiovascular Disease Risk ◽  
Onset Time ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Nighttime Sleep

Background Disrupted nighttime sleep has been associated with heart failure (HF). However, the relationship between daytime napping, an important aspect of sleep behavior commonly seen in older adults, and HF remains unclear. We sought to investigate the association of objectively assessed daytime napping and risk of incident HF during follow‐up. Methods and Results We studied 1140 older adults (age, 80.7±7.4 [SD] years; female sex, 867 [76.1%]) in the Rush Memory and Aging Project who had no HF at baseline and were followed annually for up to 14 years. Motor activity (ie, actigraphy) was recorded for ≈10 days at baseline. We assessed daytime napping episodes between 9 am and 7 pm objectively from actigraphy using a previously published algorithm for sleep detection. Cox proportional hazards models examined associations of daily napping duration and frequency with incident HF. Eighty‐six participants developed incident HF, and the mean onset time was 5.7 years (SD, 3.4; range, 1–14). Participants who napped longer than 44.4 minutes (ie, the median daily napping duration) showed a 1.73‐fold higher risk of developing incident HF than participants who napped <44.4 minutes. Consistently, participants who napped >1.7 times/day (ie, the median daily napping frequency) showed a 2.20‐fold increase compared with participants who napped <1.7 times/day. These associations persisted after adjustment for covariates, including nighttime sleep, comorbidities, and cardiovascular disease/risk factors. Conclusions Longer and more frequent objective napping predicted elevated future risk of developing incident HF. Future studies are needed to establish underlying mechanisms.

Sign in / Sign up

Export Citation Format

Share Document