Association Between Activity at Onset of Symptoms and Outcome of Acute Myocardial Infarction

Stewart, R.; Robertson, M. Clare; Wilkins, Gerard T.; Low, Clive J.S.; Restieaux, Norma J.

doi:10.1016/s0735-1097(96)00501-3

Cited by 20 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 In patients with preinfarction Braunwald class IIIB unstable angina, perhaps even a mild extrinsic stimulus can trigger the onset of AMI, suggesting that such patients have a lower threshold for abrupt coronary occlusion owing to the presence of vulnerable plaques. Physical activity at the onset of AMI has been associated with the severity of vascular disease, 19 and in the present study, patients with preinfarction stable angina had a slightly, but not significantly, higher incidence of multivessel disease.…”

Section: Physical Activity At the Onset Of Amisupporting

confidence: 51%

“…Previous studies have shown that patients with preinfarction angina less frequently have symptom onset during exercise than those without prior angina at the onset of AMI. 18,19 These observations might simply reflect reduced daily physical activity in patients with preinfarction angina, especially those with rest angina, but Muller et al have suggested that hemodynamic or vasoconstrictive forces generated by physical or psychologic stress might disrupt vulnerable plaques. 20 In patients with preinfarction Braunwald class IIIB unstable angina, perhaps even a mild extrinsic stimulus can trigger the onset of AMI, suggesting that such patients have a lower threshold for abrupt coronary occlusion owing to the presence of vulnerable plaques.…”

Section: Physical Activity At the Onset Of Amimentioning

confidence: 99%

See 1 more Smart Citation

Differences in Inflammatory Activity at the Onset of Acute Myocardial Infarction According to the Clinical Presentation of Preinfarction Angina

et al. 2001

View full text Add to dashboard Cite

he pathogenetic mechanisms of acute myocardial infarction (AMI) remain incompletely understood, and although many studies have shown that an underlying inflammatory process plays an important role in the pathogenesis, 1-3 the inflammatory activity differs according to the clinical severity of angina pectoris (AP). 4 We therefore postulated that pathogenetic mechanisms leading to AMI might differ according to the clinical presentation of preinfarction angina and so we examined the relation between preinfarction angina, inflammatory activity, and the onset of AMI. Plasma levels of C-reactive protein (CRP), a sensitive marker of acute inflammation, were measured in patients experiencing their first AMI in whom the serum creatine kinase levels were normal on admission and increased subsequently. Methods Patient PopulationTwo hundred eighty patients (215 men, 65 women; mean age [±SD], 60±11 years; range, 30-87) with transmural AMI who fulfilled the following inclusion criteria were admitted to our coronary care unit between

show abstract

Section: Physical Activity At the Onset Of Amisupporting

confidence: 51%

Section: Physical Activity At the Onset Of Amimentioning

confidence: 99%

Differences in Inflammatory Activity at the Onset of Acute Myocardial Infarction According to the Clinical Presentation of Preinfarction Angina

et al. 2001

View full text Add to dashboard Cite

show abstract

“…Information on the presence of triggers was obtained from interviews conducted by trained research personnel [17,22 -24,27,29,30], nurses and interns [19,21,28,31], medical staff [26,32], the attending cardiologist [25], the author herself [18] or undefined [16,20]. Some authors [21,22,28,29] precisely quantified the degree of physical activity on a scale from 1 to 8 metabolic equivalents (MET).…”

Section: Methodsmentioning

confidence: 99%

“…Accordingly, physical activity was categorized as mild-to-moderate (3 to 5 MET), heavy ( z 6 MET) or any (either mild-to-moderate or heavy; z 3 MET). Some authors [26,31] did not distinguish between types of physical activity, reporting on both activity types as one category. The triggering events defined as meal [16], overeating [17,28,31] or eating and drinking [25] in the meta-analysis were included within the ''eating'' category.…”

Section: Methodsmentioning

confidence: 99%

Meta-analysis of possible external triggers of acute myocardial infarction

Čulić

Eterović

Mirić

2005

International Journal of Cardiology

100

View full text Add to dashboard Cite

“…INTERHEART includes large numbers of individuals from all regions of the world and multiple ethnicities, making the results broadly applicable, unlike previous studies of potential triggers that were performed primarily in 1 country or region. 9,16,[18][19][20][21]39,[43][44][45][46][47] IN-TERHEART also includes only participants with first AMI, thereby reducing the possibility that altered lifestyles or risk factors resulting from previous AMI would affect our estimates. In addition, sensitivity analyses including the controls from INTERHEART using multivariable-adjusted conditional logistic regression yielded similar associations.…”

mentioning

confidence: 99%

Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction

et al. 2016

View full text Add to dashboard Cite

On behalf of the INTER-HEART InvestigatorsOriginal research article BACKGROUND: Physical exertion, anger, and emotional upset are reported to trigger acute myocardial infarction (AMI). In the INTERHEART study, we explored the triggering association of acute physical activity and anger or emotional upset with AMI to quantify the importance of these potential triggers in a large, international population. METHODS:INTERHEART was a case-control study of first AMI in 52 countries. In this analysis, we included only cases of AMI and used a casecrossover approach to estimate odds ratios for AMI occurring within 1 hour of triggers. RESULTS:Of 12 461 cases of AMI 13.6% (n=1650) engaged in physical activity and 14.4% (n=1752) were angry or emotionally upset in the case period (1 hour before symptom onset). Physical activity in the case period was associated with increased odds of AMI (odds ratio, 2.31; 99% confidence interval [CI], 1.96-2.72) with a population-attributable risk of 7.7% (99% CI,). Anger or emotional upset in the case period was associated with an increased odds of AMI (odds ratio, 2.44; 99% CI, 2.06-2.89) with a population-attributable risk of 8.5% (99% CI, 7.0-9.6). There was no effect modification by geographical region, prior cardiovascular disease, cardiovascular risk factor burden, cardiovascular prevention medications, or time of day or day of onset of AMI. Both physical activity and anger or emotional upset in the case period were associated with a further increase in the odds of AMI (odds ratio, 3.05; 99% CI, 2.29-4.07; P for interaction <0.001).CONCLUSIONS: Physical exertion and anger or emotional upset are triggers associated with first AMI in all regions of the world, in men and women, and in all age groups, with no significant effect modifiers. 1 The INTERHEART study reported that >90% of the risk of myocardial infarction was attributable to long-term exposure to 9 risk factors.2 Most longterm exposures (eg, lipids, obesity) are mediated through an intermediate phenotype (atherosclerotic change) rather than trigger acute rupture of atherosclerotic plaque, precipitating an acute myocardial infarction (AMI). Observational studies identified potential external triggers for AMI, including physical exertion and anger or emotional upset.3,4 However, with few exceptions, the included studies had small sample sizes (n<2000) and were completed primarily in 1 country or geographical region (predominantly Western countries). As with long-term exposure to cardiovascular risk factors, the prevalence of potential triggers of AMI may also vary by geographical region; triggers important in 1 region or ethnic group may be different in others. Large, international studies using standardized methodology are required to determine whether there are variations in the importance of triggering risk factors and to determine other factors that may modify the association. The INTERHEART study provides an opportunity to study the association between these potential external triggers of AMI and effect modifiers in a large,...

show abstract

Association Between Activity at Onset of Symptoms and Outcome of Acute Myocardial Infarction

Abstract: There is an association between activity at onset and outcome of acute myocardial infarction. Differences in pathophysiology or in the population at risk could explain this observation.

Cited by 20 publications

References 14 publications

Differences in Inflammatory Activity at the Onset of Acute Myocardial Infarction According to the Clinical Presentation of Preinfarction Angina

Differences in Inflammatory Activity at the Onset of Acute Myocardial Infarction According to the Clinical Presentation of Preinfarction Angina

Meta-analysis of possible external triggers of acute myocardial infarction

Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction

Contact Info

Product

Resources

About