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Diabetes, hypertension, overweight and hyperlipidemia and 7-day case-fatality in first myocardial infarction
Karolinska Inst, Inst Environm Med, Cardiovasc Epidemiol Unit, Stockholm, Sweden..
Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, Trondheim, Norway..
Karolinska Inst, Inst Environm Med, Cardiovasc Epidemiol Unit, Stockholm, Sweden.;Danderyd Hosp, Div Cardiovasc Med, Dept Clin Sci, Danderyd, Sweden..
Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden..
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2016 (English)In: International Journal of Cardiology Metabolic & Endocrine, E-ISSN 2214-7624, Vol. 12, p. 30-35Article in journal (Refereed) Published
Abstract [en]

Background: Out-of-hospital deaths due to a first myocardial infarction (MI) are frequent and a big challenge for prevention. Increased knowledge about factors influencing MI fatality is needed. Metabolic risk factors have been studied in relation to MI fatality in-hospital but studies considering also out-of-hospital deaths are few. Aim: To assess howdiabetes and other metabolic risk factors associate with death within 7 days after first time MI among subjects aged between 45 and 70 identified in Stockholm County 1992-1994. Methods: Data were collected using questionnaires (close relatives of fatal cases were asked to fill the questionnaire), physical examinations, national registers and autopsy reports. Risk ratios (RR) of 7-day MI fatality with 95% confidence intervals (CI) associated with the risk factors under study were calculated using binomial regression with log link. Results: Out of 1905 first time MI cases included, 524 died within 7 days. After adjustments for age, sex, current smoking, education and general comorbidity, diabetes, but not hypertension and hyperlipidemia, was associated with MI fatality (RR 1.68, 95% CI 1.20-2.28). Overweight, as compared to normal BMI, was inversely associated with MI fatality (multiple adjusted RR 0.68, 95% CI 0.49-0.94); obesity results pointed in the samedirection (multiple adjusted RR 0.79, 0.52-1.16). Conclusions: In this population-based inception cohort study, diabetes but not hypertension and hyperlipidemia were associated with MI fatality. This further emphasizes the importance of diabetes as a cardiovascular risk factor and the need for close surveillance of diabetic patients. Overweight was however associated with decreased MI fatality.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2016. Vol. 12, p. 30-35
Keywords [en]
Fatality, Diabetes, Hyperlipidemia, Hypertension, Myocardial infarction, Obesity, Overweight, 7-day fatality
National Category
Cardiac and Cardiovascular Systems Endocrinology and Diabetes Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-319410DOI: 10.1016/j.ijcme.2016.05.009ISI: 000395272000006OAI: oai:DiVA.org:uu-319410DiVA, id: diva2:1086829
Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2017-11-29Bibliographically approved

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