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- Title
Significant predictors of poor prognosis in women aged </=65 years hospitalized for an acute coronary event.
- Authors
Al-Khalili, F.; Svane, B.; Janszky, I.; Rydén, L.; Orth-Gomér, K.; Schenck-Gustafsson, K.; Rydén, L; Orth-Gomér, K
- Abstract
<bold>Objectives: </bold>The aim of this study was to evaluate the importance of different clinical parameters predicting long-term cardiac prognosis in younger women with an acute coronary event.<bold>Design: </bold>The Stockholm Female Coronary Risk Study is a follow-up study in women </=65 years.<bold>Setting: </bold>Patients were included between 1991 and 1994 from all 10 coronary care or intensive care units in the greater Stockholm area.<bold>Subjects: </bold>A total of 335 consecutive female patients hospitalized for an acute coronary event.<bold>Main Outcome Measures: </bold>Cardiac death and nonfatal myocardial infarction (AMI).<bold>Results: </bold>During the follow-up period of 5 years there were 26 (8%) all cause deaths and 39 (12%) recurrent cardiac events. In the group that participated in the complete study, the following age adjusted parameters were found as strong predictors of adverse outcome: AMI as index event [Hazard Ratio (HR) 9.13, 95% CI 3.09-26.99], diabetes mellitus (HR 4.13, 95% CI 1.68-10.17), left ventricular dysfunction (HR 3.94, 95% CI 1.52-10.17), serum HDL cholesterol <1.0 mmol L-1 (HR 4.01, 95% CI 1.62-6.12), and serum triglycerides >2.0 mmol L-1 (HR 2.46, 95% CI 1.06-5.54). AMI as index event and diabetes mellitus were the most significant predictors in a multivariate statistical model. Diabetes mellitus was the strongest predictor when the analysis was repeated in the total patient cohort, integrating patients that did not participate in the extended investigations.<bold>Conclusion: </bold>Women aged </=65-year-old hospitalized for an acute coronary event has a low rate of cardiac events during the following 5-year period. Easily obtained clinical variables such as diabetes mellitus predict adverse prognosis and implicates a need for a more active diagnostic and treatment strategy.
- Subjects
CORONARY disease; WOMEN'S health; HEART diseases
- Publication
Journal of Internal Medicine, 2002, Vol 252, Issue 6, p561
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1046/j.1365-2796.2002.01070.x