Midlife Cardiovascular Risk Factors and Late-Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND-MI, the AGES-Reykjavik Study.
Midlife Cardiovascular Risk Factors and Late-Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND-MI, the AGES-Reykjavik Study.
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DOI：
10.1161/jaha.115.002420
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发表时间：
2016-02-12
影响因子：
5.4
通讯作者：
Arai AE
中科院分区：
文献类型：
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作者：
McAreavey D;Vidal JS;Aspelund T;Eiriksdottir G;Schelbert EB;Kjartansson O;Cao JJ;Thorgeirsson G;Sigurdsson S;Garcia M;Harris TB;Launer LJ;Gudnason V;Arai AE
动脉粥样硬化危险因素与未识别心肌梗死（UMI）的关系尚不清楚。我们研究了中年危险因素与UMI的关系，并在31年后通过心脏磁共振检测到了确认的MI（RMI）。雷克雅未克研究（1967-1991）收集了受试者的一系列风险因素，平均（SD）年龄为48（7）岁。在ICELAND-MI（2004-2007）中，通过心脏磁共振评价了936例存活者（76（5）岁）。分析包括逻辑回归和随机效应模型。比较是相对于无MI的受试者。在基线中年评估中，改良的Fragrance风险评分在RMI和UMI组显著高于无MI组（7.4（6.3）%; 7.1（6.2）% vs 5.4（5.8）%，P<0.001）。RMI和UMI在男性中更常见（65%，64%对43%; P<0.0001）。UMI患者的基线收缩压和舒张压显著升高（138（17）mm Hg vs 133（17）mm Hg; P<0.006; 87（10）mm Hg vs 84（10）mm Hg; P<0.02）。RMI组舒张压明显高于对照组（88（10）mm Hg vs 84（10）mm Hg; P<0.02）。RMI组的胆固醇和甘油三酯显著升高（6.7（1.1）mmol/L vs 6.2（1.1）mmol/L; P=0.0005; 1.4（0.7）mmol/L vs 1.1（0.7）mmol/L; P<0.003）。UMI组胆固醇有升高趋势（P=0.08）。UMI组的连续中年收缩压显著高于无MI组（β [SE] = 2.69 [1.28] mm Hg，P=0.04）。与无MI组相比，RMI组的连续收缩压和舒张压显著升高（4.12 [1.60] mm Hg，P=0.01和2.05 [0.91] mm Hg，P=0.03），胆固醇（0.43 [0.11] mmol/L，P=0.0001）和甘油三酯（0.3 [0.06] mmol/L，P<0.0001）也是如此。中年血管危险因素与31年后心脏磁共振检测到的UMI和RMI相关。收缩压是与晚期UMI相关的最重要的可改变的危险因素。
Associations of atherosclerosis risk factors with unrecognized myocardial infarction (UMI) are unclear. We investigated associations of midlife risk factors with UMI and recognized MI (RMI) detected 31 years later by cardiac magnetic resonance. The Reykjavik Study (1967–1991) collected serial risk factors in subjects, mean (SD) age 48 (7) years. In ICELAND‐MI (2004–2007), 936 survivors (76 (5) years) were evaluated by cardiac magnetic resonance. Analysis included logistic regression and random effects modeling. Comparisons are relative to subjects without MI. At baseline midlife evaluation, a modified Framingham risk score was significantly higher in RMI and in UMI versus no MI (7.4 (6.3)%; 7.1 (6.2)% versus 5.4 (5.8)%, P<0.001). RMI and UMI were more frequent in men (65%, 64% versus 43%; P<0.0001). Baseline systolic and diastolic blood pressure were significantly higher in UMI (138 (17) mm Hg versus 133 (17) mm Hg; P<0.006; 87 (10) mm Hg versus 84 (10) mm Hg; P<0.02). Diastolic BP was significantly higher in RMI (88 (10) mm Hg versus 84 (10) mm Hg; P<0.02). Cholesterol and triglycerides were significantly higher in RMI (6.7 (1.1) mmol/L versus 6.2 (1.1) mmol/L; P=0.0005; and 1.4 (0.7) mmol/L versus 1.1 (0.7) mmol/L; P<0.003). Cholesterol trended higher in UMI (P=0.08). Serial midlife systolic BP was significantly higher in UMI versus no MI (β [SE] = 2.69 [1.28] mm Hg, P=0.04). Serial systolic and diastolic BP were significantly higher in RMI versus no MI (4.12 [1.60] mm Hg, P=0.01 and 2.05 [0.91] mm Hg, P=0.03) as were cholesterol (0.43 [0.11] mmol/L, P=0.0001) and triglycerides (0.3 [0.06] mmol/L, P<0.0001). Midlife vascular risk factors are associated with UMI and RMI detected by cardiac magnetic resonance 31 years later. Systolic blood pressure was the most significant modifiable risk factor associated with later UMI.