Risk factors for first-time acute myocardial infarction patients in Trinidad

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

The relative importance of coronary artery disease (CAD) risk varies globally. The aim of this study was to determine CAD risk factors for acute myocardial infarction (AMI) among patients in public health care institutions in Trinidad using a case–control type study design.

Methods

The sample comprised 251 AMI patients hospitalized between March 1, 2011 and April 30, 2012 and 464 age- and sex-matched non-AMI patients with no terminal or life-threatening illness and who did not undergo treatment for CAD. SPSS version 19 was used for data analysis that included chi-square tests, unadjusted and adjusted odds ratios (OR) and conditional multiple binary logistic regression.

Results

There was no difference in age between AMI and non-AMI patients ( p = 0.551). Chi-square test revealed that clinical and lifestyle variables including stressful life, diabetes, hypertension, hypercholesterolaemia, ischaemic heart disease (IHD), a family history of IHD ( p ≤ 0.001), smoking ( p = 0.007) and alcohol consumption ( p = 0.013) were associated with AMI; sex ( p = 0.441), ethnicity ( p = 0.366), age group ( p = 0.826) and renal failure ( p = 0.487) were not.

Both unadjusted and adjusted (for age) ORs showed that the odds of hypertension, IHD and alcohol consumption were greater among AMI patients than among non-AMI patients for males; diabetes and IHD for females; and that the odds of a stressful life was greater among non-AMI patients and were the same for both groups with respect to sex, age > 45 years, hypercholesterolemia, renal insufficiency, and family history of IHD.

Conditional multiple logistic regression showed that smoking [OR: 0.274, p ≤ 0.001, 95% CI for OR (0.140, 0.537)], a stressful life [OR: 2.697, p ≤ 0.001, 95% CI for OR (1.585, 4.587)], diabetes [OR: 0.530, p = 0.020, 95% CI for OR (0.310, 0.905)], hypertension [OR: 0.48, p = 0.10. 95% CI for OR (0.275, 0.837)] and IHD [OR: 0.111, p ≤ 0.001, 95% CI for OR (0.057, 0.218)] were the only useful AMI predictors.

Conclusions

Smoking, diabetes, hypertension, IHD and decrease stress are useful AMI predictors.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications.

Bongani M Mayosi, Bernard Gersh, Karen Sliwa … (2010)

The epidemic of cardiovascular disease (CVD) is a global phenomenon, and the magnitude of its increase in incidence and prevalence in low- and middle-income countries (LIMIC) has potentially major implications for those high-income countries that characterize much of the developed world. Cardiovascular disease remains the leading cause of death in the world and approximately 80% of all cardiovascular-related deaths occur in LIMIC and at a younger age in comparison to high-income countries. The economic impact in regard to loss of productive years of life and the need to divert scarce resources to tertiary care is substantial. The 'epidemiologic transition' provides a useful framework for understanding changes in the patterns of disease as a result of societal and socioeconomic developments in different countries and regions of the world. A burning but as yet unanswered question is whether gains made over the last four decades in reducing cardiovascular mortality in high-income countries will be offset by changes in risk factor profiles, and in particular obesity and diabetes. Much of the population attributable risk of myocardial infarction is accountable on the basis of nine modifiable traditional risk factors, irrespective of geography. Developing societies are faced with a hostile cardiovascular environment, characterized by changes in diet, exercise, the effects of tobacco, socioeconomic stressors, and economic constraints at both the national and personal level in addition to exposure to potential novel risk factors and perhaps a genetic or programmed foetal vulnerability to CVD in later life. There are major challenges for primary and secondary prevention including lack of data, limited national resources, and the lack of prediction models in certain populations. There are two major approaches to prevention: public health/community-based strategies and clinic-based with a targeted approach to high-risk patients and combinations of these. There are concerns that in comparison with communicable diseases, cardiovascular and chronic diseases have a relatively low priority in the global health agenda and that this requires additional emphasis. The human race has had long experience and a fine tradition in surviving adversity, but we now face a task for which we have little experience, the task of surviving prosperity Alan Gregg 1890-1957, Rockefeller Foundation.

0 comments Cited 123 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Depression and other psychological risks following myocardial infarction.

Nancy Smith, François Lespérance (2003)

There is consistent evidence that depression symptoms predict long-term mortality following a myocardial infarction, and recent results show a dose-related gradient. The importance of other psychological variables remains unclear. This study examines the relative importance of depression, anxiety, anger, and social support in predicting 5-year cardiac-related mortality following a myocardial infarction and assesses the role of any common underlying dimensions. The design of this cohort analytic study involves self-reports (Beck Depression Inventory, state scale of the State-Trait Anxiety Inventory, 20-item version of the General Health Questionnaire, Modified Somatic Perception Questionnaire, Anger Expression Scale, Perceived Social Support Scale, number of close friends and relatives, and visual analog scales of anger and stress). The study was conducted in 10 Montreal-area hospitals. The patients included 896 persons who experienced a myocardial infarction, aged 24 to 88 years (232 were women), followed up for 5 years using Medicare records; baseline data were complete for 95.0% of the patients. The intervention was usual care, and the main outcome measure was 5-year cardiac-related mortality. The Beck Depression Inventory (P<.001), the State-Trait Anxiety Inventory (P =.04), and the 20-item version of the General Health Questionnaire (P =.048) were related to outcome), but only depression remained significant after adjustment for cardiac disease severity (hazards ratio per SD, 1.46; 95% confidence interval, 1.18-1.79) (P<.001). Exploratory factor analysis revealed 3 underlying factors: negative affectivity, overt anger, and social support. There was also a covariate-adjusted trend between negative affectivity scores and outcome (P =.08). Furthermore, residual depression scores (P =.001) and negative affectivity scores (P =.05) were linked to cardiac-related mortality after adjustment for each other and cardiac covariates. Negative affectivity and some unique aspect of depression predict long-term cardiac-related mortality following a myocardial infarction independently of each other and cardiac disease severity. Additional research is needed to characterize the mechanisms involved.

0 comments Cited 48 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

CVD risk factors and ethnicity--a homogeneous relationship?

Naveed Sattar, Nita Forouhi (2006)

Current understanding of cardiovascular disease risk (CVD) is derived largely from studies of Caucasians of European origin. However, people of certain ethnic groups experience a disproportionately greater burden of CVD including coronary heart disease (CHD) and stroke. Adoption of a Westernised lifestyle has different effects on metabolic and vascular dysfunction across populations, e.g. South Asians have a higher prevalence of coronary heart disease (CHD) and cardiovascular mortality compared with Europeans. African-Americans demonstrate higher rates of CHD and stroke while African/Caribbeans in the UK have lower CHD rates and higher stroke rates than British Europeans. Other non-European groups such as the Chinese and Japanese exhibit consistently high rates of stroke but not CHD, while Mexican Americans have a higher prevalence of both stroke and CHD, and North American native Indians also have high rates of CHD. While conventional cardiovascular risk factors such as smoking, blood pressure and total cholesterol predict risk within these ethnic groups, they do not fully account for the differences in risk between ethnic groups, suggesting that alternative explanations might exist. Ethnic groups show differences in levels of visceral adiposity, insulin resistance, and novel risk markers such as C-reactive protein (CRP), adiponectin and plasma homocysteine. The marked differences across racial and ethnic groups in disease risk are likely due in part to each of genetic, host susceptibility and environmental factors, and can provide valuable aetiological clues to differences in patterns of disease presentation, therapeutic needs and response to treatment. Ongoing studies should increase understanding of ethnicity as a potential independent risk factor, thus enabling better identification of treatment targets and selection of therapy in specific populations.

0 comments Cited 40 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

M. Bahall: 1 868 763 6608 , vmandrakes@hotmail.com

T. Seemungal: tseemungal@aol.com

G. Legall: legall.george@gmail.com

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 19 January 2018

Publication date PMC-release: 19 January 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 161

Affiliations

[1 ]GRID grid.430529.9, School of Medicine, Faculty of Medical Sciences, , University of the West Indies, Eric Williams Medical Sciences Complex, Mt. Hope, ; Trinidad, Trinidad and Tobago

[2 ]Trinidad, Trinidad and Tobago

Article

Publisher ID: 5080

DOI: 10.1186/s12889-018-5080-y

PMC ID: 5775614

PubMed ID: 29351744

SO-VID: 52bccf34-ec1c-4f78-948c-9a3b9cbdb932

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 27 June 2017

Date accepted : 15 January 2018

Custom metadata

ScienceOpen disciplines: Public health

Keywords: risk factors,trinidad,acute myocardial infarction,case–control study

Data availability:

ScienceOpen disciplines: Public health

Keywords: risk factors, trinidad, acute myocardial infarction, case–control study

Risk factors for first-time acute myocardial infarction patients in Trinidad

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Global Health Next Generation Network

Most cited references 33

Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications.

Depression and other psychological risks following myocardial infarction.

CVD risk factors and ethnicity--a homogeneous relationship?

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 314

Cited by 4

Most referenced authors 692