TY - JOUR
T1 - Sex and classic risk factors after myocardial infarction
T2 - a community study
AU - Gerber, Yariv
AU - Weston, Susan A.
AU - Killian, Jill M.
AU - Jacobsen, Steven J.
AU - Roger, Véronique L.
N1 - Funding Information:
This study was supported by the grants from the Public Health Service and the National Institutes of Health (AR30582, R01 HL 59205 and R01 HL 72435), Bethesda, MD and a Postdoctoral Fellowship Award from the American Heart Association, Greater Midwest Affiliate (0525753Z; Dr Gerber), Dallas, TX.
PY - 2006/9
Y1 - 2006/9
N2 - Background: Sex-specific data on classic risk factors and their impact after myocardial infarction (MI) in the community are lacking. We evaluated the prevalence and association of classic risk factors with recurrent ischemic events in patients with MI and tested the hypothesis that they differed by sex. Methods: All patients (1104, 45% women) from Olmsted County, Minnesota, hospitalized with an incident MI between 1990 and 1998 were identified using standardized criteria and followed-up (mean 3.7 years) for recurrent ischemic events, defined as recurrent MI, ischemic stroke, or coronary death. Data on hypertension, diabetes, hypercholesterolemia, smoking, and obesity at index hospitalization were analyzed individually and in clusters. Results: Women were older than men (73 vs 64 years, P < .001) and had more risk factors. During follow-up, 423 events occurred. For women, the adjusted risk of recurrent events increased with hypertension, diabetes, and hypercholesterolemia. For men, no increase in risk was detected with any risk factor. The population attributable risk of all risk factors combined was 46% (95% CI 29%-62%) in women and 19% (95% CI 6%-35%) in men. As the number of risk factors increased from 1 to ≥4, compared with no risk factors, the adjusted hazard ratio in women increased progressively (1.12, 1.82, 2.34, and 2.68, respectively), whereas no trend was detected in men (1.40, 1.27, 1.24, and 1.37, respectively) (P = .01 for effect modification by sex). Conclusions: Classic risk factors are highly prevalent and often clustered in MI, especially among women. Although their predictive value for recurrent ischemic events is marginal in men, strong associations exist in women, which define secondary prevention opportunities.
AB - Background: Sex-specific data on classic risk factors and their impact after myocardial infarction (MI) in the community are lacking. We evaluated the prevalence and association of classic risk factors with recurrent ischemic events in patients with MI and tested the hypothesis that they differed by sex. Methods: All patients (1104, 45% women) from Olmsted County, Minnesota, hospitalized with an incident MI between 1990 and 1998 were identified using standardized criteria and followed-up (mean 3.7 years) for recurrent ischemic events, defined as recurrent MI, ischemic stroke, or coronary death. Data on hypertension, diabetes, hypercholesterolemia, smoking, and obesity at index hospitalization were analyzed individually and in clusters. Results: Women were older than men (73 vs 64 years, P < .001) and had more risk factors. During follow-up, 423 events occurred. For women, the adjusted risk of recurrent events increased with hypertension, diabetes, and hypercholesterolemia. For men, no increase in risk was detected with any risk factor. The population attributable risk of all risk factors combined was 46% (95% CI 29%-62%) in women and 19% (95% CI 6%-35%) in men. As the number of risk factors increased from 1 to ≥4, compared with no risk factors, the adjusted hazard ratio in women increased progressively (1.12, 1.82, 2.34, and 2.68, respectively), whereas no trend was detected in men (1.40, 1.27, 1.24, and 1.37, respectively) (P = .01 for effect modification by sex). Conclusions: Classic risk factors are highly prevalent and often clustered in MI, especially among women. Although their predictive value for recurrent ischemic events is marginal in men, strong associations exist in women, which define secondary prevention opportunities.
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U2 - 10.1016/j.ahj.2006.02.003
DO - 10.1016/j.ahj.2006.02.003
M3 - Article
C2 - 16923413
AN - SCOPUS:33747194485
SN - 0002-8703
VL - 152
SP - 461
EP - 468
JO - American heart journal
JF - American heart journal
IS - 3
ER -