Related Experiment Videos
Risk factors for myocardial infarction in Brazil
Leopoldo S Piegas1, Alvaro Avezum, Júlio César R Pereira
1Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil. idpc@sti.com.br
Insights
Smoking, diabetes, and obesity are key risk factors for acute myocardial infarction (AMI) in Brazil. These preventable factors highlight the need for public health policies to manage cardiovascular disease effectively.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular diseases, particularly acute myocardial infarction (AMI), cause a significant proportion of global deaths, with developing countries disproportionately affected.
- Evaluating risk factors for AMI in Brazil is critical for effective disease management in this large Latin American nation.
Purpose of the Study:
- To identify and evaluate independent risk factors associated with a first ST-segment elevation acute myocardial infarction (AMI) in Brazil.
- To provide data for the development of targeted public health interventions and policies.
Main Methods:
- The study employed a case-control, hospital-based design known as the Acute Myocardial Infarction Risk Factor Assessment in Brazil (AFIRMAR).
- Data were collected from 1279 pairs of patients matched for age and sex across 104 hospitals in 51 Brazilian cities.
- Conditional multivariable analysis was used to determine independent risk factors for AMI.
Main Results:
- Key independent risk factors identified include smoking (≥5 cigarettes/day: OR 4.90; <5 cigarettes/day: OR 2.07), elevated glucose (≥126 mg/dL: OR 2.82), and central obesity (waist/hip ratio ≥0.94: OR 2.45; 0.90-0.93: OR 1.52).
- Other significant risk factors include a family history of coronary artery disease (CAD), elevated low-density lipoprotein-cholesterol (LDL-C) levels, reported hypertension, and reported diabetes mellitus.
- Interestingly, regular alcohol consumption (up to 2 days/week: OR 0.75; 3-7 days/week: OR 0.60) and higher family income with college education (OR 0.68) were associated with a reduced risk.
Conclusions:
- The identified risk factors for AMI in Brazil align with conventional patterns, notably smoking, diabetes mellitus, and central obesity.
- These risk factors exhibit varying strengths of association and are largely preventable, underscoring the importance of implementing effective public health policies.
Background:
Approximately three-quarters of cardiovascular disease deaths in the world come from developing countries, and acute myocardial infarction (AMI) is an important cause of death. Brazil is one of the largest countries in Latin America and the contemporary evaluation of risk factors for AMI is crucial for a more efficacious disease management.
Methods:
The Acute Myocardial Infarction Risk Factor Assessment in Brazil (AFIRMAR) study is a case-control, hospital-based study involving 104 hospitals in 51 cities in Brazil, designed to evaluate risk factors for a first ST-segment elevation AMI.
Results:
A total of 1279 pairs, matched by age (+/- 5 years) and sex, were enrolled. The conditional multivariable analysis of 33 variables showed the following independent risk factors for AMI: > or =5 cigarettes per day (odds ratio [OR] 4.90, P <.00001); glucose > or =126 mg/dL (OR 2.82, P <.00001); waist/hip ratio > or =0.94 (OR 2.45, P <.00001); family history of CAD (OR 2.29, P <.00001), low-density lipoprotein-cholesterol 100 to 120 mg/dL (OR 2.10, P <.00001); reported hypertension (OR 2.09, P <.00001); <5 cigarettes per day (OR 2.07, P =.0171); low-density lipoprotein-cholesterol >120 mg/dL (OR 1.75, P <.00001); reported diabetes mellitus (OR 1.70, P =.0069); waist/hip ratio 0.90 to 0.93 (OR 1.52, P =.0212); alcohol intake (up to 2 days/week) (OR 0.75, P <.0309); alcohol intake (3-7 days/week) (OR 0.60, P =.0085); family income R$600 to R$1200 and college education (OR 2.92, P =.0499); family income >R$1200 and college education (OR 0.68, P = 0.0239)
Conclusions:
The independent risk factors for AMI in Brazil showed a conventional distribution pattern (smoking, diabetes mellitus and central obesity among others) with different strengths of association; most of them being preventable by implementation of adequate policies.