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Cardiovascular risk factors and clinical presentation in acute coronary syndromes

Objective: To investigate the hypothesis that risk factors may be differently related to severity of acute coronary syndromes (ACS), with ST elevation used as a marker of severe ACS. Design: Cross sectional study of patients with ACS. Setting: 103 hospitals in 25 countries in Europe and the Mediterr... Full description

Journal Title: Heart (British Cardiac Society) 2005-09, Vol.91 (9), p.1141-1147
Main Author: Rosengren, A
Other Authors: Wallentin, L , Simoons, M , Gitt, A K , Behar, S , Battler, A , Hasdai, D
Format: Electronic Article Electronic Article
Language: English
Subjects:
ACS
AMI
BMI
CI
OR
Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 1355-6037
Zum Text:
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recordid: cdi_swepub_primary_oai_gup_ub_gu_se_52974
title: Cardiovascular risk factors and clinical presentation in acute coronary syndromes
format: Article
creator:
  • Rosengren, A
  • Wallentin, L
  • Simoons, M
  • Gitt, A K
  • Behar, S
  • Battler, A
  • Hasdai, D
subjects:
  • Abridged Index Medicus
  • ACS
  • Acute coronary syndromes
  • Acute Disease
  • acute myocardial infarction
  • Adult
  • Aged
  • AMI
  • Analysis
  • Angina pectoris
  • ARIC
  • Atherosclerosis (general aspects, experimental research)
  • atherosclerosis risk in the communities
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • BMI
  • Body Mass Index
  • Cardiac and Cardiovascular Systems
  • Cardiology. Vascular system
  • Cardiovascular Medicine
  • CI
  • confidence interval
  • Coronary Disease - etiology
  • Coronary Disease - physiopathology
  • Coronary Disease/etiology/physiopathology
  • Coronary heart disease
  • Cross-Sectional Studies
  • Diabetes Mellitus - physiopathology
  • Electrocardiogram
  • Electrocardiography
  • Female
  • Health Surveys
  • Heart
  • Heart attacks
  • Humans
  • hypertension
  • Hypertension - complications
  • Kardiologi
  • macromolecular substances
  • Male
  • Medical and Health Sciences
  • Medical sciences
  • Medicin och hälsovetenskap
  • Middle Aged
  • Mortality
  • musculoskeletal
  • myocardial infarction
  • nervous system
  • neural
  • Obesity
  • Obesity - complications
  • ocular physiology
  • Odds Ratio
  • OR
  • Risk Factors
  • Risk factors (Health)
  • smoking
  • Smoking - adverse effects
  • Syndrome
  • Trends
  • unstable angina pectoris
ispartof: Heart (British Cardiac Society), 2005-09, Vol.91 (9), p.1141-1147
description: Objective: To investigate the hypothesis that risk factors may be differently related to severity of acute coronary syndromes (ACS), with ST elevation used as a marker of severe ACS. Design: Cross sectional study of patients with ACS. Setting: 103 hospitals in 25 countries in Europe and the Mediterranean basin. Patients: 10 253 patients with a discharge diagnosis of ACS in the Euro heart survey of ACS. Main outcome measures: Presenting with ST elevation ACS. Results: Patients with ACS who were smokers had an increased risk to present with ST elevation (age adjusted odds ratio (OR) 1.84, 95% confidence interval (CI) 1.67 to 2.02). Hypertension (OR 0.65, 95% CI 0.60 to 0.70) and high body mass index (BMI) (p for trend 0.0005) were associated with less ST elevation ACS. Diabetes mellitus was also associated with less ST elevation, but only among men. Prior disease (infarction, chronic angina, revascularisation) and treatment with aspirin, β blockers, or statins before admission were also associated with less ST elevation. After adjustment for age, sex, prior disease, and prior medication, smoking was still significantly associated with increased risk of ST elevation (OR 1.53, 95% CI 1.38 to 1.69), whereas hypertension was associated with reduced risk (OR 0.75, 95% CI 0.69 to 0.82). Obesity (BMI > 30 kg/m2 versus < 25 kg/m2) was independently associated with less risk of presenting with ST elevation among women, but not among men. Conclusion: Among patients with ACS, presenting with ST elevation is strongly associated with smoking, whereas hypertension and high BMI (in women) are associated with less ST elevation, independently of prior disease and medication.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
  • 1468-201X
url: Link


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creatorRosengren, A ; Wallentin, L ; Simoons, M ; Gitt, A K ; Behar, S ; Battler, A ; Hasdai, D
creatorcontribRosengren, A ; Wallentin, L ; Simoons, M ; Gitt, A K ; Behar, S ; Battler, A ; Hasdai, D ; Sahlgrenska akademin ; Institute of Internal Medicine ; Göteborgs universitet ; Gothenburg University ; Institutionen för invärtesmedicin ; Sahlgrenska Academy
descriptionObjective: To investigate the hypothesis that risk factors may be differently related to severity of acute coronary syndromes (ACS), with ST elevation used as a marker of severe ACS. Design: Cross sectional study of patients with ACS. Setting: 103 hospitals in 25 countries in Europe and the Mediterranean basin. Patients: 10 253 patients with a discharge diagnosis of ACS in the Euro heart survey of ACS. Main outcome measures: Presenting with ST elevation ACS. Results: Patients with ACS who were smokers had an increased risk to present with ST elevation (age adjusted odds ratio (OR) 1.84, 95% confidence interval (CI) 1.67 to 2.02). Hypertension (OR 0.65, 95% CI 0.60 to 0.70) and high body mass index (BMI) (p for trend 0.0005) were associated with less ST elevation ACS. Diabetes mellitus was also associated with less ST elevation, but only among men. Prior disease (infarction, chronic angina, revascularisation) and treatment with aspirin, β blockers, or statins before admission were also associated with less ST elevation. After adjustment for age, sex, prior disease, and prior medication, smoking was still significantly associated with increased risk of ST elevation (OR 1.53, 95% CI 1.38 to 1.69), whereas hypertension was associated with reduced risk (OR 0.75, 95% CI 0.69 to 0.82). Obesity (BMI > 30 kg/m2 versus < 25 kg/m2) was independently associated with less risk of presenting with ST elevation among women, but not among men. Conclusion: Among patients with ACS, presenting with ST elevation is strongly associated with smoking, whereas hypertension and high BMI (in women) are associated with less ST elevation, independently of prior disease and medication.
identifier
0ISSN: 1355-6037
1ISSN: 1468-201X
2EISSN: 1468-201X
3DOI: 10.1136/hrt.2004.051508
4PMID: 16103541
languageeng
publisherLondon: BMJ Publishing Group Ltd and British Cardiovascular Society
subjectAbridged Index Medicus ; ACS ; Acute coronary syndromes ; Acute Disease ; acute myocardial infarction ; Adult ; Aged ; AMI ; Analysis ; Angina pectoris ; ARIC ; Atherosclerosis (general aspects, experimental research) ; atherosclerosis risk in the communities ; Biological and medical sciences ; Blood and lymphatic vessels ; BMI ; Body Mass Index ; Cardiac and Cardiovascular Systems ; Cardiology. Vascular system ; Cardiovascular Medicine ; CI ; confidence interval ; Coronary Disease - etiology ; Coronary Disease - physiopathology ; Coronary Disease/etiology/physiopathology ; Coronary heart disease ; Cross-Sectional Studies ; Diabetes Mellitus - physiopathology ; Electrocardiogram ; Electrocardiography ; Female ; Health Surveys ; Heart ; Heart attacks ; Humans ; hypertension ; Hypertension - complications ; Kardiologi ; macromolecular substances ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Mortality ; musculoskeletal ; myocardial infarction ; nervous system ; neural ; Obesity ; Obesity - complications ; ocular physiology ; Odds Ratio ; OR ; Risk Factors ; Risk factors (Health) ; smoking ; Smoking - adverse effects ; Syndrome ; Trends ; unstable angina pectoris
ispartofHeart (British Cardiac Society), 2005-09, Vol.91 (9), p.1141-1147
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0Rosengren, A
1Wallentin, L
2Simoons, M
3Gitt, A K
4Behar, S
5Battler, A
6Hasdai, D
7Sahlgrenska akademin
8Institute of Internal Medicine
9Göteborgs universitet
10Gothenburg University
11Institutionen för invärtesmedicin
12Sahlgrenska Academy
title
0Cardiovascular risk factors and clinical presentation in acute coronary syndromes
1Heart (British Cardiac Society)
addtitleHeart
descriptionObjective: To investigate the hypothesis that risk factors may be differently related to severity of acute coronary syndromes (ACS), with ST elevation used as a marker of severe ACS. Design: Cross sectional study of patients with ACS. Setting: 103 hospitals in 25 countries in Europe and the Mediterranean basin. Patients: 10 253 patients with a discharge diagnosis of ACS in the Euro heart survey of ACS. Main outcome measures: Presenting with ST elevation ACS. Results: Patients with ACS who were smokers had an increased risk to present with ST elevation (age adjusted odds ratio (OR) 1.84, 95% confidence interval (CI) 1.67 to 2.02). Hypertension (OR 0.65, 95% CI 0.60 to 0.70) and high body mass index (BMI) (p for trend 0.0005) were associated with less ST elevation ACS. Diabetes mellitus was also associated with less ST elevation, but only among men. Prior disease (infarction, chronic angina, revascularisation) and treatment with aspirin, β blockers, or statins before admission were also associated with less ST elevation. After adjustment for age, sex, prior disease, and prior medication, smoking was still significantly associated with increased risk of ST elevation (OR 1.53, 95% CI 1.38 to 1.69), whereas hypertension was associated with reduced risk (OR 0.75, 95% CI 0.69 to 0.82). Obesity (BMI > 30 kg/m2 versus < 25 kg/m2) was independently associated with less risk of presenting with ST elevation among women, but not among men. Conclusion: Among patients with ACS, presenting with ST elevation is strongly associated with smoking, whereas hypertension and high BMI (in women) are associated with less ST elevation, independently of prior disease and medication.
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0Abridged Index Medicus
1ACS
2Acute coronary syndromes
3Acute Disease
4acute myocardial infarction
5Adult
6Aged
7AMI
8Analysis
9Angina pectoris
10ARIC
11Atherosclerosis (general aspects, experimental research)
12atherosclerosis risk in the communities
13Biological and medical sciences
14Blood and lymphatic vessels
15BMI
16Body Mass Index
17Cardiac and Cardiovascular Systems
18Cardiology. Vascular system
19Cardiovascular Medicine
20CI
21confidence interval
22Coronary Disease - etiology
23Coronary Disease - physiopathology
24Coronary Disease/etiology/physiopathology
25Coronary heart disease
26Cross-Sectional Studies
27Diabetes Mellitus - physiopathology
28Electrocardiogram
29Electrocardiography
30Female
31Health Surveys
32Heart
33Heart attacks
34Humans
35hypertension
36Hypertension - complications
37Kardiologi
38macromolecular substances
39Male
40Medical and Health Sciences
41Medical sciences
42Medicin och hälsovetenskap
43Middle Aged
44Mortality
45musculoskeletal
46myocardial infarction
47nervous system
48neural
49Obesity
50Obesity - complications
51ocular physiology
52Odds Ratio
53OR
54Risk Factors
55Risk factors (Health)
56smoking
57Smoking - adverse effects
58Syndrome
59Trends
60unstable angina pectoris
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authorRosengren, A ; Wallentin, L ; Simoons, M ; Gitt, A K ; Behar, S ; Battler, A ; Hasdai, D
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1ACS
2Acute coronary syndromes
3Acute Disease
4acute myocardial infarction
5Adult
6Aged
7AMI
8Analysis
9Angina pectoris
10ARIC
11Atherosclerosis (general aspects, experimental research)
12atherosclerosis risk in the communities
13Biological and medical sciences
14Blood and lymphatic vessels
15BMI
16Body Mass Index
17Cardiac and Cardiovascular Systems
18Cardiology. Vascular system
19Cardiovascular Medicine
20CI
21confidence interval
22Coronary Disease - etiology
23Coronary Disease - physiopathology
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25Coronary heart disease
26Cross-Sectional Studies
27Diabetes Mellitus - physiopathology
28Electrocardiogram
29Electrocardiography
30Female
31Health Surveys
32Heart
33Heart attacks
34Humans
35hypertension
36Hypertension - complications
37Kardiologi
38macromolecular substances
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40Medical and Health Sciences
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44Mortality
45musculoskeletal
46myocardial infarction
47nervous system
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51ocular physiology
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1Wallentin, L
2Simoons, M
3Gitt, A K
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notes
0Correspondence to:
 Dr Annika Rosengren
 Department of Medicine, Sahlgrenska University Hospital/Östra, SE-416 85 Goteborg, Sweden; Annika.Rosengren@hjl.gu.se
1The locally appointed ethics committees approved the study protocol, informed consent was obtained from participants if required by the ethics committee, and the study was done in compliance with the Declaration of Helsinki.
2Correspondence to: …Dr Annika Rosengren …Department of Medicine, Sahlgrenska University Hospital/Östra, SE-416 85 Goteborg, Sweden; Annika.Rosengren@hjl.gu.se
3Conflict of interest: none
abstractObjective: To investigate the hypothesis that risk factors may be differently related to severity of acute coronary syndromes (ACS), with ST elevation used as a marker of severe ACS. Design: Cross sectional study of patients with ACS. Setting: 103 hospitals in 25 countries in Europe and the Mediterranean basin. Patients: 10 253 patients with a discharge diagnosis of ACS in the Euro heart survey of ACS. Main outcome measures: Presenting with ST elevation ACS. Results: Patients with ACS who were smokers had an increased risk to present with ST elevation (age adjusted odds ratio (OR) 1.84, 95% confidence interval (CI) 1.67 to 2.02). Hypertension (OR 0.65, 95% CI 0.60 to 0.70) and high body mass index (BMI) (p for trend 0.0005) were associated with less ST elevation ACS. Diabetes mellitus was also associated with less ST elevation, but only among men. Prior disease (infarction, chronic angina, revascularisation) and treatment with aspirin, β blockers, or statins before admission were also associated with less ST elevation. After adjustment for age, sex, prior disease, and prior medication, smoking was still significantly associated with increased risk of ST elevation (OR 1.53, 95% CI 1.38 to 1.69), whereas hypertension was associated with reduced risk (OR 0.75, 95% CI 0.69 to 0.82). Obesity (BMI > 30 kg/m2 versus < 25 kg/m2) was independently associated with less risk of presenting with ST elevation among women, but not among men. Conclusion: Among patients with ACS, presenting with ST elevation is strongly associated with smoking, whereas hypertension and high BMI (in women) are associated with less ST elevation, independently of prior disease and medication.
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