In never-smokers, passive smoking at home appeared to be associated with the risk of AMI, and approximately 14% of cases in men and 18% of cases in women in this Argentinian cohort are attributable to passive smoking.
The relationship between overweight and obesity and the risk of acute nonfatal myocardial infarction was analyzed, using data from a case-control study from Buenos Aires, Argentina. The study included 1000 patients with acute myocardial infarction and 1000 controls, who had been admitted to the same hospitals in which the cases had been identified, for acute conditions unrelated to known or potential risk factors for coronary heart disease. Only 32% of the cases and 41% of the controls had a Quetelet's index (body mass index, BMI, kg m-2) under 25% of the cases and 51% of the controls were overweight (BMI 25 to 30), and 15% of the cases and 8% of the controls severely obese (BMI > 30). After allowance for age and sex, the relative risks (RR) were 1.4 (95% confidence interval, CI, 1.1 to 1.7) for subjects with a body mass index of 25 to 30 and 2.2 (95% CI 1.7 to 3.1) for those with a body mass index more than 30. When additional adjustment was made for hypertension, diabetes, smoking and a family history of coronary heart disease, the RR was 1.2 (95% CI 1.0 to 1.6) among subjects with a body mass index of 25 to 30 and 1.7 (95% CI 1.3 to 2.4) for those with a body mass index more than 30. The trend in risk was significant. In the stratified analysis, the RR in younger people (30-44 years) with a body mass index more than 30 was 4.7 (95% CI 2.0 to 10.8), and the association was less strong in middle and older age.(ABSTRACT TRUNCATED AT 250 WORDS)
In forty-five patients who underwent orthotopic heart transplantation, the titer of anti-human skeletal muscle glycolipid antibodies (AGA) present in the sera at the moment of transplantation was correlated with the number of histologically diagnosed cellular grade 3A and humoral acute rejection episodes during the first 120 days after transplantation. Determination of a cutoff value of 0.800 for the AGA level was determined by a receiver operating characteristic curve. Thirteen of 19 patients (68.4%) with an AGA titer above 0.800 developed 24 severe rejection episodes, and of the 26 patients with an AGA titer below 0.800, only 4 (15.3%) presented 6 severe rejection episodes during that time. This was especially evident for the humoral rejection episodes, which were diagnosed in only 1 of the 26 patients with AGA below 0.800 and in 7 of the 19 with AGA above 0.800. Comparison by univariate analysis of other well-known risk factors for a greater number of rejection episodes during the early posttransplant period with the AGA level at the moment of transplantation revealed that the latter distinguished a greater number of patients at risk than the other factors, such as a female donor, the lymphocyte direct cross-match, or the status of the patients at transplantation; the odds ratios were 6.33 for the AGA level, 3.17 for the direct cross-match, and 2.76 for the status at transplantation. By multiple logistic regression analysis, the only relevant risk factors in our group of patients were the AGA level (P=0.0009) and the status at transplantation (P=0.0285). These results indicate that determination of the AGA level at the moment of transplantation could represent a useful method for distinguishing which patients are at risk for a greater number of rejection episodes during the early posttransplant period, with a greater sensitivity than other risk factors.
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