Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study
Background Unrecognized myocardial infarction (MI) is a frequent and intriguing entity associated with a similar risk of death as recognized MI. Previous studies have not fully addressed whether the poor prognosis is explained by traditional cardiovascular risk factors. We investigated whether elect...
Published in: | European Journal of Preventive Cardiology |
---|---|
Main Authors: | , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Oxford University Press (OUP)
2017
|
Subjects: | |
Online Access: | http://dx.doi.org/10.1177/2047487317736826 http://journals.sagepub.com/doi/pdf/10.1177/2047487317736826 http://journals.sagepub.com/doi/full-xml/10.1177/2047487317736826 |
id |
croxfordunivpr:10.1177/2047487317736826 |
---|---|
record_format |
openpolar |
spelling |
croxfordunivpr:10.1177/2047487317736826 2024-04-28T08:40:45+00:00 Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study Øhrn, Andrea Milde Schirmer, Henrik Njølstad, Inger Mathiesen, Ellisiv B Eggen, Anne E Løchen, Maja-Lisa Wilsgaard, Tom Lindekleiv, Haakon 2017 http://dx.doi.org/10.1177/2047487317736826 http://journals.sagepub.com/doi/pdf/10.1177/2047487317736826 http://journals.sagepub.com/doi/full-xml/10.1177/2047487317736826 en eng Oxford University Press (OUP) http://journals.sagepub.com/page/policies/text-and-data-mining-license European Journal of Preventive Cardiology volume 25, issue 1, page 78-86 ISSN 2047-4873 2047-4881 Cardiology and Cardiovascular Medicine Epidemiology journal-article 2017 croxfordunivpr https://doi.org/10.1177/2047487317736826 2024-04-02T08:08:03Z Background Unrecognized myocardial infarction (MI) is a frequent and intriguing entity associated with a similar risk of death as recognized MI. Previous studies have not fully addressed whether the poor prognosis is explained by traditional cardiovascular risk factors. We investigated whether electrocardiographically detected unrecognized MI was independently associated with cardiovascular events and death and whether it improved prediction for future MI in a general population. Design Prospective cohort study. Methods We studied 5686 women and men without clinically recognized MI at baseline in 2007–2008. We assessed the risk of future MI, stroke and all-cause mortality in persons with unrecognized MI compared with persons with no MI during 31,051 person-years of follow-up. Results In the unadjusted analyses, unrecognized MI was associated with increased risk of future recognized MI (hazard ratio 1.84, 95% confidence interval (CI) 1.15–2.96) and all-cause mortality (hazard ratio 1.78, 95% CI 1.21–2.61), but not stroke (hazard ratio 1.09, 95% CI 0.56–2.17). The associations did not remain significant after adjustment for traditional risk factors (hazard ratio 1.25, 95% CI 0.76–2.06 and hazard ratio 1.38, 95% CI 0.93–2.05) for MI and all-cause mortality respectively. Unrecognized MI did not improve risk prediction for future recognized MI using the Framingham Risk Score ( p = 0.96) or the European Systematic COronary Risk Evaluation ( p = 0.65). There was no significant sex interaction regarding any of the endpoints. Conclusion Electrocardiographic unrecognized MI was not significantly associated with future risk of MI, stroke or all-cause mortality in the general population after adjustment for the traditional cardiovascular risk factors, and it did not improve prediction of future MI. Article in Journal/Newspaper Tromsø Oxford University Press European Journal of Preventive Cardiology 25 1 78 86 |
institution |
Open Polar |
collection |
Oxford University Press |
op_collection_id |
croxfordunivpr |
language |
English |
topic |
Cardiology and Cardiovascular Medicine Epidemiology |
spellingShingle |
Cardiology and Cardiovascular Medicine Epidemiology Øhrn, Andrea Milde Schirmer, Henrik Njølstad, Inger Mathiesen, Ellisiv B Eggen, Anne E Løchen, Maja-Lisa Wilsgaard, Tom Lindekleiv, Haakon Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
topic_facet |
Cardiology and Cardiovascular Medicine Epidemiology |
description |
Background Unrecognized myocardial infarction (MI) is a frequent and intriguing entity associated with a similar risk of death as recognized MI. Previous studies have not fully addressed whether the poor prognosis is explained by traditional cardiovascular risk factors. We investigated whether electrocardiographically detected unrecognized MI was independently associated with cardiovascular events and death and whether it improved prediction for future MI in a general population. Design Prospective cohort study. Methods We studied 5686 women and men without clinically recognized MI at baseline in 2007–2008. We assessed the risk of future MI, stroke and all-cause mortality in persons with unrecognized MI compared with persons with no MI during 31,051 person-years of follow-up. Results In the unadjusted analyses, unrecognized MI was associated with increased risk of future recognized MI (hazard ratio 1.84, 95% confidence interval (CI) 1.15–2.96) and all-cause mortality (hazard ratio 1.78, 95% CI 1.21–2.61), but not stroke (hazard ratio 1.09, 95% CI 0.56–2.17). The associations did not remain significant after adjustment for traditional risk factors (hazard ratio 1.25, 95% CI 0.76–2.06 and hazard ratio 1.38, 95% CI 0.93–2.05) for MI and all-cause mortality respectively. Unrecognized MI did not improve risk prediction for future recognized MI using the Framingham Risk Score ( p = 0.96) or the European Systematic COronary Risk Evaluation ( p = 0.65). There was no significant sex interaction regarding any of the endpoints. Conclusion Electrocardiographic unrecognized MI was not significantly associated with future risk of MI, stroke or all-cause mortality in the general population after adjustment for the traditional cardiovascular risk factors, and it did not improve prediction of future MI. |
format |
Article in Journal/Newspaper |
author |
Øhrn, Andrea Milde Schirmer, Henrik Njølstad, Inger Mathiesen, Ellisiv B Eggen, Anne E Løchen, Maja-Lisa Wilsgaard, Tom Lindekleiv, Haakon |
author_facet |
Øhrn, Andrea Milde Schirmer, Henrik Njølstad, Inger Mathiesen, Ellisiv B Eggen, Anne E Løchen, Maja-Lisa Wilsgaard, Tom Lindekleiv, Haakon |
author_sort |
Øhrn, Andrea Milde |
title |
Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
title_short |
Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
title_full |
Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
title_fullStr |
Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
title_full_unstemmed |
Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study |
title_sort |
electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. the tromsø study |
publisher |
Oxford University Press (OUP) |
publishDate |
2017 |
url |
http://dx.doi.org/10.1177/2047487317736826 http://journals.sagepub.com/doi/pdf/10.1177/2047487317736826 http://journals.sagepub.com/doi/full-xml/10.1177/2047487317736826 |
genre |
Tromsø |
genre_facet |
Tromsø |
op_source |
European Journal of Preventive Cardiology volume 25, issue 1, page 78-86 ISSN 2047-4873 2047-4881 |
op_rights |
http://journals.sagepub.com/page/policies/text-and-data-mining-license |
op_doi |
https://doi.org/10.1177/2047487317736826 |
container_title |
European Journal of Preventive Cardiology |
container_volume |
25 |
container_issue |
1 |
container_start_page |
78 |
op_container_end_page |
86 |
_version_ |
1797571292377907200 |