Recurrence and Mortality in Young Women With Myocardial Infarction or Ischemic Stroke

Maino, Alberto; Siegerink, Bob; Algra, Ale; Peyvandi, Flora; Rosendaal, Frits R.

doi:10.1001/jamainternmed.2015.6523

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…28 Maino et al stated that young women who survived a cardiovascular event have a high long-term mortality and morbidity when compared with the general population. 29 We revealed in this study that the thromboembolic events were the most frequent in the 40s, and the ATE ratio for overall thromboembolism tended to increase with advancing age (P = 0.0041). We understand that a ratio of ATE among overall thromboembolism tends to relatively increase with aging, though the incidence of VTE itself does not decrease with aging.…”

Section: Discussionmentioning

confidence: 54%

The incidence and prognosis of thromboembolism associated with oral contraceptives: Age‐dependent difference in Japanese population

Sugiura

Ojima

Urano

et al. 2018

J of Obstet and Gynaecol

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AimWe analyzed the incidence and prognosis of thromboembolism associated with combined oral contraceptives (COCs) by age groups in Japan.MethodsA total of 581 events of venous thromboembolism (VTE) and arterial thromboembolism (ATE) associated with COCs were analyzed from the Pharmaceuticals and Medical Devices Agency database from 2004 to 2013. In a statistical analysis, a good‐prognosis group included recovery cases and a poor‐prognosis group involved unrecovered cases with some sequela and fatal cases. The significant difference between these two groups was calculated by Pearson's chi‐square test, and the age‐specific tendency and the trend of differences in prognosis according to different hormonal contraceptives were examined by Cochran–Armitage trend test.ResultsA total of 543 events were analyzed except 38 events due to unknown age, in which DVT only was the most frequent, followed by cerebral infarction, PE with DVT, PE only, cerebral vein thromboses. ATE ratio for overall thromboembolism tended to increase with advancing age (P = 0.0041). Good‐prognosis group was common (291 cases in VTE and 83 cases in ATE), followed by poor‐prognosis group (46 cases in VTE and 34 cases in ATE). All ATE cases had a significantly poorer prognosis in comparison with all VTE cases (P < 0.0001). Types of progestin and age difference, however, showed no trend in the differences between good‐prognosis group and poor‐prognosis group (P = 0.3548 and P = 0.6097).ConclusionThromboembolic events were the most frequent in the 40s. The ATE ratio for overall thromboembolism tended to increase with advancing age. All ATE cases had a significantly poorer prognosis in comparison with all VTE cases.

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Section: Discussionmentioning

confidence: 54%

The incidence and prognosis of thromboembolism associated with oral contraceptives: Age‐dependent difference in Japanese population

Sugiura

Ojima

Urano

et al. 2018

J of Obstet and Gynaecol

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“…We used data from the Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) follow-up study, based on subjects who participated in the RATIO case-control study [12]. For the present study two groups of patients, subjects who survived either a myocardial infarction or an ischaemic stroke, were included.…”

Section: Methodsmentioning

confidence: 99%

Hypercoagulability and the risk of recurrence in young women with myocardial infarction or ischaemic stroke: a cohort study

Maino

Algra

Peyvandi

et al. 2019

BMC Cardiovasc Disord

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Background We aimed to investigate the role of hypercoagulability on the risk of lifetime cardiovascular recurrences after myocardial infarction or ischaemic stroke. Methods Young women (< 50 years) with either myocardial infarction ( n = 197) or ischaemic stroke ( n = 107) were followed between 1995 and 2012 in the RATIO follow-up study. To determine whether hypercoagulability affects the risk or recurrence, a coagulation score based on acquired and inherited markers was compiled and used in a quartile analysis. Hazard ratios (HRs) obtained from Cox proportional models and adjusted for several cardiovascular risk factors were used to compare quartiles of the coagulation score for the risk of recurrence. Results During a median follow-up of 19 years, 59 cardiovascular recurrences occurred. In patients with myocardial infarction no association was found between a high prothrombotic score and recurrences (highest quartile vs lowest quartile HR 0.7, 95% CI, 0.3–1.8). Conversely, ischaemic stroke patients with a high prothrombotic score showed a doubling in risk of long-term cardiovascular recurrences (HR 1.9, 95% CI 0.6–6.3) compared with ischaemic stroke patients and low levels of the score, with a dose response relationship. Conclusions An increased coagulation tendency might be associated with long-term cardiovascular risk in women with ischaemic stroke, but not in women with myocardial infarction.

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“…32 Also, mutations and dysfunctions of factor V Leiden are associated with a high risk of cardiovascular events, being more commonly reported in smokers and in those who use oral contraceptives, because they increase the risk through their procoagulant effect. 33,34 Connective tissue diseases, through chronic systemic inflammation, and sometimes through long-term therapy, favor coronary atherosclerosis. Although coronary artery disease could complicate the development of connective tissue disease, AMI is a rarely reported entity in these cases, most often through coronary vasculitis and/ or atherothrombotic occlusive lesions.…”

Section: Other Cardiovascular Risk Factorsmentioning

confidence: 99%

“…31 Contraceptive medication has been reported in 40% of women who have had an AMI. 33 However, studies have shown a favorable effect on venous thrombosis, less on arterial blood pressure. Data related to AMI in this group are contradictory, being influenced by the generation of contraceptives used, the presence or absence of smoking, high blood pressure or prothrombotic status, which may increase by 10 times the risk of myocardial infarction.…”

Section: Other Cardiovascular Risk Factorsmentioning

confidence: 99%

Particularities of Acute Myocardial Infarction in Young Adults

Anghel

Prisacariu

Sascău

et al. 2019

Journal of Cardiovascular Emergencies

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Coronary heart disease occurs more often in patients over the age of 45. However, recent data shows a growing incidence of coronary events in younger patients also. Young patients with acute myocardial infarction (AMI) represent a relatively small proportion of subjects suffering from an acute ischemic event. However, they represent a subset that is distinguished from elderly patients by a different profile of risk factors, often atypical clinical presentation, and different prognosis. The prevalence of risk factors such as smoking, dyslipidemia, and a family history of coronary events is higher in this group of patients compared to the general population with AMI. Because of an important negative impact on the patients’ psychology, impaired working abilities, and a high socioeconomical burden, myocardial infarction in young patients represents an important cardiovascular pathology. This manuscript aims to present the particularities of AMI occuring at a young age, in comparison with the rest of the population with AMI.

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Recurrence and Mortality in Young Women With Myocardial Infarction or Ischemic Stroke

Abstract: Drs Maino and Siegerink had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 15 publications

References 7 publications

The incidence and prognosis of thromboembolism associated with oral contraceptives: Age‐dependent difference in Japanese population

The incidence and prognosis of thromboembolism associated with oral contraceptives: Age‐dependent difference in Japanese population

Hypercoagulability and the risk of recurrence in young women with myocardial infarction or ischaemic stroke: a cohort study

Particularities of Acute Myocardial Infarction in Young Adults

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