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Cardiovascular risk factors and autonomic indices in relation to fatal and non-fatal coronary events

Zambach, Christian LU orcid ; Fedorowski, Artur LU orcid ; Borné, Yan LU ; Johnson, Linda S B LU ; Gerward, Sofia LU ; Hamrefors, Viktor LU orcid and Engström, Gunnar LU (2021) In Open Heart 8(1).
Abstract

OBJECTIVE: Mortality caused by coronary artery disease has markedly decreased in recent years. However, a substantial proportion of patients suffering a coronary event (CE) die within the first day, most of them out of hospital. We aimed to investigate how established cardiovascular (CV) risk factors and CV autonomic indices associate with fatal versus non-fatal CEs in the population.

METHODS: 33 057 individuals (mean age; 45.6 years; 10 773 women) free of coronary artery disease at baseline were included. Baseline examination, including assessment of traditional CV risk factors and autonomic indices such as heart rate and orthostatic reaction, was performed during 1974-1992, after which the subjects were monitored for incident CV... (More)

OBJECTIVE: Mortality caused by coronary artery disease has markedly decreased in recent years. However, a substantial proportion of patients suffering a coronary event (CE) die within the first day, most of them out of hospital. We aimed to investigate how established cardiovascular (CV) risk factors and CV autonomic indices associate with fatal versus non-fatal CEs in the population.

METHODS: 33 057 individuals (mean age; 45.6 years; 10 773 women) free of coronary artery disease at baseline were included. Baseline examination, including assessment of traditional CV risk factors and autonomic indices such as heart rate and orthostatic reaction, was performed during 1974-1992, after which the subjects were monitored for incident CV disease. The Lunn-McNeil competing risks approach with a prespecified multivariable model was used to assess differences in risks for fatal and non-fatal CEs in relation to baseline CV risk factors.

RESULTS: During follow-up period of 29.7 years, 5494 subjects (6.10/1000 person-years) had first CE; 1554 of these were fatal. Age, male gender, smoking, body mass index (BMI), blood pressure, pulse pressure and resting heart rate had stronger relationships with fatal CE than with non-fatal events. The effects of diabetes, serum cholesterol, antihypertensive treatment and orthostatic blood pressure responses were similar for fatal and non-fatal CE.

CONCLUSIONS: Several cardiovascular risk factors, such as smoking, high BMI, blood pressure and high resting heart rate, were preferentially associated with fatal compared with non-fatal CEs. These observations may require special attention in the overall efforts to further reduce coronary artery disease mortality.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Open Heart
volume
8
issue
1
article number
e001445
publisher
BMJ Publishing Group
external identifiers
  • pmid:33879505
  • scopus:85104791866
ISSN
2053-3624
DOI
10.1136/openhrt-2020-001445
language
English
LU publication?
yes
id
e1485669-5df8-4d55-b5c7-f533a01b3387
date added to LUP
2021-04-23 09:52:26
date last changed
2024-07-13 12:49:37
@article{e1485669-5df8-4d55-b5c7-f533a01b3387,
  abstract     = {{<p>OBJECTIVE: Mortality caused by coronary artery disease has markedly decreased in recent years. However, a substantial proportion of patients suffering a coronary event (CE) die within the first day, most of them out of hospital. We aimed to investigate how established cardiovascular (CV) risk factors and CV autonomic indices associate with fatal versus non-fatal CEs in the population.</p><p>METHODS: 33 057 individuals (mean age; 45.6 years; 10 773 women) free of coronary artery disease at baseline were included. Baseline examination, including assessment of traditional CV risk factors and autonomic indices such as heart rate and orthostatic reaction, was performed during 1974-1992, after which the subjects were monitored for incident CV disease. The Lunn-McNeil competing risks approach with a prespecified multivariable model was used to assess differences in risks for fatal and non-fatal CEs in relation to baseline CV risk factors.</p><p>RESULTS: During follow-up period of 29.7 years, 5494 subjects (6.10/1000 person-years) had first CE; 1554 of these were fatal. Age, male gender, smoking, body mass index (BMI), blood pressure, pulse pressure and resting heart rate had stronger relationships with fatal CE than with non-fatal events. The effects of diabetes, serum cholesterol, antihypertensive treatment and orthostatic blood pressure responses were similar for fatal and non-fatal CE.</p><p>CONCLUSIONS: Several cardiovascular risk factors, such as smoking, high BMI, blood pressure and high resting heart rate, were preferentially associated with fatal compared with non-fatal CEs. These observations may require special attention in the overall efforts to further reduce coronary artery disease mortality.</p>}},
  author       = {{Zambach, Christian and Fedorowski, Artur and Borné, Yan and Johnson, Linda S B and Gerward, Sofia and Hamrefors, Viktor and Engström, Gunnar}},
  issn         = {{2053-3624}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Open Heart}},
  title        = {{Cardiovascular risk factors and autonomic indices in relation to fatal and non-fatal coronary events}},
  url          = {{http://dx.doi.org/10.1136/openhrt-2020-001445}},
  doi          = {{10.1136/openhrt-2020-001445}},
  volume       = {{8}},
  year         = {{2021}},
}