Lifestyle variables and the risk of myocardial infarction in the general practice research database.
Lifestyle variables and the risk of myocardial infarction in the general practice research database.
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DOI：
10.1186/1471-2261-7-38
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发表时间：
2007-12-18
影响因子：
2.1
通讯作者：
Suissa, Samy
中科院分区：
文献类型：
--
作者：
Delaney, Joseph A C;Daskalopoulou, Stella S;Suissa, Samy
背景技术背景：本研究的主要目的是评估体重指数（BMI）与首次急性心肌梗死（AMI）风险之间的关系。作为一个次要目标，我们认为其他生活方式变量，吸烟和大量饮酒，和AMI risk.METHODS：这项研究进行了全科医学研究数据库（GPRD），这是一个数据库的基础上全科医生的记录，是一个有代表性的英国人口样本。我们采用发病率密度抽样法，将2001年1月1日至2005年12月31日期间由诊断代码确定的首次AMI病例与最多10例对照进行匹配。我们使用多重插补来解释缺失的数据。结果：我们确定了19,353例首次AMI病例，这些病例在索引日期、GPRD实践和年龄上与192,821例对照组相匹配。数据库中有少量缺失数据，缺失数据的患者与记录值的患者具有不同的风险。我们对每个生活方式变量以及过去一年的年龄、性别和住院次数进行了调整。尽管体重过轻（BMI ≥ 30 kg/m2）的记录预测风险增加（调整后OR：1.41; 95% CI：1.35-1.47）。吸烟史也预示着AMI的风险增加（调整后OR：1.81; 95% CI：1.75-1.87）（调整后OR：1.15; 95% CI：1.06-1.26）。这项研究表明，肥胖，吸烟和酗酒，在常规护理记录由全科医生，是首次AMI风险增加的重要预测因素。相反，低BMI不会增加首次AMI的风险。
BACKGROUND: The primary objective of this study is to estimate the association between body mass index (BMI) and the risk of first acute myocardial infarction (AMI). As a secondary objective, we considered the association between other lifestyle variables, smoking and heavy alcohol use, and AMI risk.METHODS: This study was conducted in the general practice research database (GPRD) which is a database based on general practitioner records and is a representative sample of the United Kingdom population. We matched cases of first AMI as identified by diagnostic codes with up to 10 controls between January 1st, 2001 and December 31st, 2005 using incidence density sampling. We used multiple imputation to account for missing data.RESULTS: We identified 19,353 cases of first AMI which were matched on index date, GPRD practice and age to 192,821 controls. There was a modest amount of missing data in the database, and the patients with missing data had different risks than those with recorded values. We adjusted our analysis for each lifestyle variable jointly and also for age, sex, and number of hospitalizations in the past year. Although a record of underweight (BMI or =30 kg/m2) predicted an increased risk (adjusted OR: 1.41; 95% CI: 1.35-1.47). A history of smoking also predicted an increased risk of AMI (adjusted OR: 1.81; 95% CI: 1.75-1.87) as did heavy alcohol use (adjusted OR: 1.15; 95% CI: 1.06-1.26).CONCLUSION: This study illustrates that obesity, smoking and heavy alcohol use, as recorded during routine care by a general practitioner, are important predictors of an increased risk of a first AMI. In contrast, low BMI does not increase the risk of a first AMI.