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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relation between coffee consumption and the risk of acute myocardial infarction was evaluated in a hospital-based case-control study conducted in northern Italy between 1983 and 1987. The study consisted of 262 women with acute myocardial infarction and 519 controls admitted to the hospital for acute, nondigestive tract disorders. Information was obtained on the average number of cups of coffee or decaffeinated coffee consumed per day before the onset of the disease which led to hospital admission and on the total duration in years of the habit. There was a positive association between heavy coffee drinking and risk of myocardial infarction (relative risk (RR) = 2.7 for consumption of four cups or more per day). After allowance for smoking and other relevant covariates, the relative risk was not elevated for consumption of up to three cups per day, but still above unity for consumption of four or more cups per day (RR = 1.7), and the multivariate trend in risk was still significant (X1(2) = 5.14, p = 0.02). The risk estimates were grossly elevated among hyperlipidemic women (multivariate RR = 7.6 for moderate and 17.9 for heavy coffee drinkers). As a result of small absolute numbers, these estimates were largely unstable and the interaction between coffee and hyperlipidemia was not statistically significant. Such estimates, nonetheless, are of potential interest in terms of etiologic correlates and implications for prevention.
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PMID:Coffee consumption and myocardial infarction in women. 276 93

The long-term survival rate following acute myocardial infarction (AMI) was studied in 358 patients in central Japan who were monitored for 8 to 20 years after discharge from hospital for AMI. Fifteen-year cardiac survival rates were 65% in males and 72% in females. In both sexes, the survival rate decreased with increasing age at the time of AMI. The survival rate was significantly lower in recurrent MI than in first MI patients. Those who had smoked cigarettes before AMI or had hyperlipidemia during hospitalization did not show any significant decrease in cardiac survival rate, which may be due to cessation of smoking or control of hyperlipidemia after AMI. The 15-year survival rate was significantly lower in patients with a past history of angina pectoris or hypertension. Patients with a large infarct had a lower survival rate, as did those with a large cardiothoracic ratio on chest x-ray, and those who received digitalis during hospitalization. On the other hand, patients who were administered anticoagulants during hospitalization had a higher survival rate. Multiple regression analysis gave similar results. In conclusion, factors that reduced long-term survival rate after AMI were older age at time of the first attack, reduced cardiac function, and a history of angina pectoris or hypertension. Anticoagulant therapy appeared to improve the long-term survival rate.
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PMID:Influence of risk factors on long-term survival following acute myocardial infarction: a follow-up study in central Japan. 279 70

Coronary heart disease (CHD) mortality has been decreasing continuously in all age-sex groups in Japan since 1976. An earlier increase in the 1950s was largely due to a change in the diagnostic method. Hypertension was a more important risk factor than hyperlipidaemia for ischaemic heart disease (IHD) in Japan. Increasing availability of a variety of foods supplying balanced nutrition, opportunities for health screening linked to detection and treatment of high blood pressure with little financial constraint, plus health insurance and health education have improved the cardiovascular health of the people, though these effects have not been evaluated objectively. These changes resulted in less advanced coronary atherosclerosis and less CHD despite a high frequency of smoking in men. Improving technology in the treatment of acute myocardial infarction (MI) may also have contributed to the decline in mortality.
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PMID:Changing CHD mortality and its causes in Japan during 1955-1985. 280 96

Late changes are frequent in saphenous vein grafts. About 10 to 12 years after bypass, about one-third are occluded, one-third have wall irregularities and narrowings attributed to atherosclerosis and one-third are seemingly intact. These changes are associated with recurrence of angina and other deleterious clinical events such as unstable angina, acute myocardial infarction, heart failure and death. Intimal fibrous hyperplasia may be a precursor of these changes, which could be minimized by appropriate surgical technologies and perhaps antiplatelet therapy. These late changes appear related to serum hyperlipidemia and smoking. Optimal control of these risk factors may retard their development and subsequent clinical deterioration. Although internal mammary artery (IMA) graft is the conduit of choice because of its apparent immunity to premature atherosclerosis, and hence its longer durability, saphenous vein grafts are still placed in many old patients and others, when a short operation time is a priority, and above all in combination with IMA grafts in order to obtain complete revascularization.
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PMID:Late changes in saphenous vein coronary artery bypass grafts and their implications in clinical practice. 350 31

The epidemiology and etiology, pathophysiology, diagnosis, clinical presentation, complications, and treatment of acute myocardial infarction (AMI) are reviewed. Major risk factors for AMI include age, sex (men greater than women), family history, race, hyperlipidemia, hypertension, cigarette smoking, diabetes mellitus, and diet. AMI occurs when there is a prolonged decrease in oxygen supply to the myocardium caused by coronary thrombosis or coronary vascular spasm. Traditional drug treatment of uncomplicated AMI includes oxygen, laxatives, and analgesics. For analgesia, narcotic agonists are generally preferred, although intravenous nitroglycerin is of value for both reducing infarct size and relieving pain. Fibrinolytic therapy is also indicated in these patients. Low-dose heparin should be initiated on admission to the hospital. Beta-adrenergic blocking agents have proven useful in reducing the incidence of ventricular fibrillation and sudden death. Antiplatelet agents may also be used to decrease long-term mortality. Recent studies have focused on reduction of infarct size using agents such as beta blockers, calcium-channel blockers, nitroglycerin, and thrombolytics. Revascularization procedures are required in some patients to re-establish adequate coronary perfusion. Most patients who survive AMI initially have a relatively uncomplicated clinical course. An increasing number of therapeutic interventions are available for acute and chronic treatment of AMI.
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PMID:Current concepts in clinical therapeutics: acute myocardial infarction. 352 26

The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.
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PMID:Risk factors for myocardial infarction in young women. 356 57

The clinical features and course of 30 patients (26 men and 4 women) under 30 years of age (mean age 27.3 years) with an acute myocardial infarction (MI) are described. The most common risk factor among this group of patients was smoking in 20 patients (66%). The prevalence of the other risk factors was low: hyperlipidemia in four patients and family history of ischemic disease in another four patients, diabetes mellitus, hypertension, and obesity each in one patient. Seven patients (23%) had none of the conventional risk factors. Three patients were exerting themselves prior to the onset of their MI pain; all of them had normal coronaries. Five patients experienced chest pain prior to MI, among them only two experienced classical angina pectoris. Eighteen patients underwent uncomplicated MI. The complications in the other 12 during the acute MI were rhythm disturbances in eight and congestive heart failure in four. Cardiac catheterization was performed in 25 patients. The occurrence of zero, one, or multivessel disease was equal. The 30 patients were followed up from six months to 15 years (mean 7 years). In 18 patients circulating aggregated platelets were measured one year after the MI. Elevated values were found in all of them (mean +/- SD 34.9 +/- 9.1%). In 6 of the 18, all heavy smokers, extreme values were found in the range of 39-55%. Three out of the 30 patients died within five years after their first MI. The other 15 patients developed complications, most of them angina pectoris. Five patients were hospitalized for reinfarction. None of the 30 underwent aortocoronary bypass operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Myocardial infarction in young adults under 30 years: risk factors and clinical course. 381 21

The electrocardiogram as a quantitative predictor of left ventricular systolic function was investigated in subjects with one myocardial infarction. The first 509 consecutive subjects to enter the Program of Surgical Control of Hyperlipidemia were studied by selective left ventriculography. Electrocardiograms taken during a prior hospitalization of the subjects for acute myocardial infarction were classified according to the Minnesota Q-QS codes. This study showed that the lower (ie, the more significant) Q-QS codes were highly correlated with reduced left ventricular function as measured both by a lower ejection fraction and by a greater number of left ventricular segments showing abnormal systolic motion. In addition, the location of segmental wall motion abnormalities correlated with the electrocardiographic site of the Q-QS code.
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PMID:Quantitative assessment of left ventricular function after myocardial infarction using the minnesota Q-QS codes for resting electrocardiograms. 389 72

2 young, menstruating females without any of the major risk factors (hypertension, diabetes mellitus, hyperlipidemia) developed acute myocaridal infarctions while taking oral contraceptives; their clinical histories and laboratory and arteriographic studies are presented. In the first patient (aged 29) who took Ortho-Novum 2 mg. for 11 months prior to infarction and who had an abnormal glucose tolerance test, selective coronary angiography revealed a segmental occlusion of the proximal left anterior descending coronary artery. In the second patient (aged 38) who took Enovid for several years prior to infarction, selective coronary angiography showed slight irregularity of the left anterior descending coronary artery; no evidence of akinesis or dyskinesis of the ventricular wall was noted. Although incidence of coronary artery disease in young, menstruating women has always been very low, recently there have been scattered case reports of women with acute myocardial infarction in absence of major risk factors; all cases shared the common features of oral contraceptive use prior to infarction, and unusual distribution and peculiar appearance of lesions in coronary arteries. Such reports, although rare, in young females taking synthetic estrogen do suggest that a relationship may exist between oral contraceptive agents and thromboembolic phenomena, especially coronary thrombosis. Mechanisms by which oral contraceptives might precipitate thrombosis are discussed. It is suggested that coronary artery disease should be suspected in young oral contraceptors suffering chest pain even though they are still menstruating and are free of major risk factors.
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PMID:Coronary thrombosis in young women on oral contraceptives: report of two cases and review of the literature. 470 63

The purpose of this study was to investigate the degree of platelet activation and thrombin generation in 40 patients with stable angina pectoris and in 20 patients with acute myocardial infarction (AMI) by determining the plasma beta thromboglobulin (BTG) and fibrinopeptide A (FPA) concentrations. In patients with angina pectoris increased platelet activation correlated with extensive coronary pathology; the activation, however, was not influenced by a previous myocardial infarction, use of oral anticoagulants, beta-blocking agents, or hyperlipidemia. The plasma beta thromboglobulin concentration predicted more accurately the extent of the coronary artery disease than the functional angina pectoris classification. Thrombin generation was within the normal range. In patients with acute myocardial infarction increased platelet activation and enhanced thrombin generation were found, which were not related to the infarct localization, infarct size, or the presence of complications. Consequently, in these patients determination of plasma beta thromboglobulin and fibrinopeptide A concentrations is useless for the diagnosis of venous thromboembolism.
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PMID:Fibrinopeptide A and beta thromboglobulin in patients with angina pectoris and acute myocardial infarction. 619 72


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