What does this research mean for the field?

Approximately 50% of acute myocardial infarctions occur as the first manifestation of ischemic heart disease, and hypertensive individuals are more likely to experience preceding angina due to left ventricular hypertrophy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 1, 2002Open Access

Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors

WMWaldomiro Carlos ManfróiUniversidade Federal do Rio Grande CPCarolina PeukertUniversidade Federal do Rio Grande do Sul CBClarissa Bacha BertiUniversidade Federal do Rio Grande do Sul

Structured PICO

Are cardiovascular risk factors associated with acute myocardial infarction presenting as the first manifestation of ischemic heart disease?

Population

104 patients with previous acute myocardial infarction, 72.1% male, 90.4% white, 73.1% older than 55 years.

Outcome

Acute myocardial infarction as the first manifestation of ischemic heart disease (absence of angina prior to acute myocardial infarction)

Approximately half of patients presenting with acute myocardial infarction have it as their first manifestation of ischemic heart disease, while those with hypertension and left ventricular hypertrophy are more likely to experience preceding angina.

Abstract

OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04) and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03). The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.

Ask AI

Helpful

Bookmark

View Full Paper