Scores for Post–Myocardial Infarction Risk Stratification in the Community

Singh, Mandeep; Reeder, Guy S.; Jacobsen, Steven J.; Weston, Susan A.; Killian, Jill M.; Roger, Véronique L.

doi:10.1161/01.cir.0000036598.12888.de

Cited by 117 publications

(71 citation statements)

References 25 publications

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“…Indeed, in our parent community-based cohort of participants with MI, those with non-ST-segment elevation MI had similar survival to subjects with ST-segment elevation MI, thereby providing reassurance that the prevalence of ST-segment elevation MI in participants and nonparticipants did not affect outcome. 34 Because participation-associated characteristics may vary across studies, they should be systematically examined in each study to determine how they affect outcome and inference.…”

Section: Participation Clinical Characteristics and Outcomementioning

confidence: 99%

Participation Bias and Its Impact on the Assembly of a Genetic Specimen Repository for a Myocardial Infarction Cohort

Arruda‐Olson

Weston

Fridley

et al. 2007

Mayo Clinic Proceedings

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Objective-To assess participation bias in the assembly of a specimen repository for genetic studies and to examine the association of participation with outcome within the Olmsted County myocardial infarction (MI) cohort. January 1, 1979, to May 31, 2006, 3081 persons had MI in Olmsted County, MN. Face-to-face contact was used to recruit patients who were hospitalized for an acute event. Persons who had had an MI before establishment of this repository were contacted by mail. At initial contact, we sought consent to use blood samples for genetic studies. Persons who refused were contacted by mail and were asked to consent to the use of stored tissue samples. For deceased subjects, stored tissue was collected when available. Participants and Methods-FromResults-Of the 3081 persons in the Olmsted County MI cohort, 1994 participated in the study; 1007 (50.5%) blood and 987 (49.5%) tissue specimens were provided. Participants were more likely to be younger men with hypertension, comorbidities, and non-ST-segment elevation MI (all, P<. 05). Participants who provided blood specimens were more likely to have non-ST-segment elevation MI and lower Killip class than those who provided tissue. After adjustment for age, sex, hypertension, ST-segment elevation, Killip class, and comorbidities, participation was not associated with outcome. Participants who provided blood specimens were less likely to have heart failure (hazard ratio, 0.49; 95% confidence interval, 0.40-0.59; P<.01) or to die (hazard ratio, 0.16; 95% confidence interval, 0.12-0.21; P<.01) than those who provided tissue.Conclusions-A variety of sources can be used to assemble community specimen repositories. Baseline characteristics differed between participants and nonparticipants and, among participants, by specimen source. Participants who provided blood specimens had better outcomes than those who provided tissue specimens. No survival advantage was observed for participants after combining blood and tissue specimens.Participation bias occurs when comparisons are made between groups of patients who differ in determinants of outcome and when the differences are themselves related to the outcome. 1 Studies that require enrollment of participants are inherently affected by participation bias. 2 Because selective participation can threaten the external validity of studies, assessment of the magnitude of participation bias is essential to optimize the inference from these studies.Few studies in the community have examined the effect of participation bias. In one populationbased study of myocardial infarction (MI), nonparticipants were older, had greater comorbidity, and experienced poorer survival than participants. 3 A population-based study of left ventricular function reported that participation rates were lowest among the oldest, the youngest, and those with chronic obstructive pulmonary disease. 4 However, those studies did not examine the effects of participation on genetic studies of heart diseases.Population-based studies, using both established...

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Section: Participation Clinical Characteristics and Outcomementioning

confidence: 99%

Participation Bias and Its Impact on the Assembly of a Genetic Specimen Repository for a Myocardial Infarction Cohort

Arruda‐Olson

Weston

Fridley

et al. 2007

Mayo Clinic Proceedings

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“…Predictors for the risk of death, cardiovascular death and reinfarction, have been described [1][2][3]. However, the risk of stroke after long-term follow-up of AMI is less well described in the literature.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with development of stroke long‐term after myocardial infarction: experiences from the LoWASA trial

Herlitz¹,

Holm²,

Peterson³

et al. 2005

Journal of Internal Medicine

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Objective. To describe factors associated with the development of stroke during long-term follow-up after acute myocardial infarction (AMI) in the LoWASA trial. Patients. Patients who had been hospitalized for AMI were randomized within 42 days to receive either warfarin 1.25 mg plus aspirin 75 mg daily or aspirin 75 mg alone. Design. The study was performed according to the probe design, that is open treatment and blinded end-point evaluation.Setting. The study was performed in 31 hospitals in Sweden. The mean follow-up time was 5.0 years with a range of 1.7-6.7 years. Results. In all, 3300 patients were randomized in the trial, of which 194 (5.9%) developed stroke (4.2% nonhaemorrhagic, 0.5% haemorrhagic and 1.3% uncertain. The following factors appeared as independent predictors for an increased risk of stroke: age, hazard ratio and 95% confidence interval (1.07; 1.05-1.08), a history of diabetes mellitus (2.4; 1.8-3.4), a history of stroke (2.3; 1.5-3.5), a history of hypertension (2.0; 1.5-2.7) and a history of smoking (1.5;1.1-2.0). Most of these factors were also predictors of a nonhaemorrhagic stroke whereas no predictor of haemorrhagic stroke was found. Conclusion. Risk indicators for stroke long-term after AMI were increasing age, a history of either diabetes mellitus, stroke, hypertension or smoking.

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“…1,2 Risk prediction based on clinical, ECG, and biochemical, ie, cardiac troponin, markers, however, is relatively inaccurate. 3 B-type natriuretic peptide (BNP) is a circulating cardiac hormone released mainly from the ventricles in response to increased wall stretch. 4 The BNP is produced as a prohormone, proBNP, which on secretion is split into BNP and N-terminal BNP (NT-proBNP).…”

mentioning

confidence: 99%

N-Terminal Pro-Brain Natriuretic Peptide on Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes

et al. 2004

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on behalf of the Italian Working Group on Atherosclerosis, Thrombosis, and Vascular Biology and the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)Background-The prognostic value of natriuretic peptide elevations in patients with acute coronary syndromes (ACS) is still incompletely defined. We measured N-terminal pro-brain natriuretic peptide (NT-proBNP) on admission in patients with ACS and ECG evidence of myocardial ischemia. Methods and Results-The NT-proBNP was measured at a median time of 3 hours after symptom onset in 1756 patients.The outcome measure was death at 30 days, which occurred in 113 patients (6.4%). The median NT-proBNP level was 353 ng/L (107 to 1357 ng/L). Compared with the lowest quartile, patients in the second, third, and fourth quartiles had a relative risk of subsequent death of 2.94 (95% CI, 1.15 to 7.52), 5.32 (95% CI, 2.19 to 12.91), and 11.5 (95% CI, 4.90 to 26.87), respectively. The NT-proBNP was independently associated with death in a logistic regression model, which included clinical variables, ECG, and troponin T in patients either with (OR of highest versus lowest quartile, 7.0; 95% CI, 1.9 to 25.6) or without (OR of highest versus lowest quartile, 4.1; 95% CI, 1.1 to 14.6) persistent ST-segment elevation. NT-proBNP was also an independent predictor of severe heart failure. Conclusions-The

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Scores for Post–Myocardial Infarction Risk Stratification in the Community

Cited by 117 publications

References 25 publications

Participation Bias and Its Impact on the Assembly of a Genetic Specimen Repository for a Myocardial Infarction Cohort

Participation Bias and Its Impact on the Assembly of a Genetic Specimen Repository for a Myocardial Infarction Cohort

Factors associated with development of stroke long‐term after myocardial infarction: experiences from the LoWASA trial

N-Terminal Pro-Brain Natriuretic Peptide on Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes

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