Open AccessMidlife Cardiovascular Risk Factors and Late‐Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND ‐ MI , the AGES ‐Reykjavik Study
Author(s) -
McAreavey Dorothea,
Vidal JeanSébastien,
Aspelund Thor,
Eiriksdottir Gudny,
Schelbert Erik B.,
Kjartansson Olafur,
Cao Jie J.,
Thorgeirsson Gudmundur,
Sigurdsson Sigurdur,
Garcia Melissa,
Harris Tamara B.,
Launer Lenore J.,
Gudnason Vilmundur,
Arai Andrew E.
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002420
Subject(s) - medicine , myocardial infarction , cardiology , diastole , blood pressure , framingham risk score , framingham heart study , logistic regression , disease
Background Associations of atherosclerosis risk factors with unrecognized myocardial infarction ( UMI ) are unclear. We investigated associations of midlife risk factors with UMI and recognized MI ( RMI ) detected 31 years later by cardiac magnetic resonance. Methods and Results The Reykjavik Study (1967–1991) collected serial risk factors in subjects, mean ( SD ) age 48 (7) years. In ICELAND ‐ MI (2004–2007), 936 survivors (76 (5) years) were evaluated by cardiac magnetic resonance. Analysis included logistic regression and random effects modeling. Comparisons are relative to subjects without MI . At baseline midlife evaluation, a modified Framingham risk score was significantly higher in RMI and in UMI versus no MI (7.4 (6.3)%; 7.1 (6.2)% versus 5.4 (5.8)%, P <0.001). RMI and UMI were more frequent in men (65%, 64% versus 43%; P <0.0001). Baseline systolic and diastolic blood pressure were significantly higher in UMI (138 (17) mm Hg versus 133 (17) mm Hg; P <0.006; 87 (10) mm Hg versus 84 (10) mm Hg; P <0.02). Diastolic BP was significantly higher in RMI (88 (10) mm Hg versus 84 (10) mm Hg; P <0.02). Cholesterol and triglycerides were significantly higher in RMI (6.7 (1.1) mmol/L versus 6.2 (1.1) mmol/L; P =0.0005; and 1.4 (0.7) mmol/L versus 1.1 (0.7) mmol/L; P <0.003). Cholesterol trended higher in UMI ( P =0.08). Serial midlife systolic BP was significantly higher in UMI versus no MI (β [ SE ] = 2.69 [1.28] mm Hg, P =0.04). Serial systolic and diastolic BP were significantly higher in RMI versus no MI (4.12 [1.60] mm Hg, P =0.01 and 2.05 [0.91] mm Hg, P =0.03) as were cholesterol (0.43 [0.11] mmol/L, P =0.0001) and triglycerides (0.3 [0.06] mmol/L, P <0.0001). Conclusions Midlife vascular risk factors are associated with UMI and RMI detected by cardiac magnetic resonance 31 years later. Systolic blood pressure was the most significant modifiable risk factor associated with later UMI .