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[Myocardial reinfarction in male and female]
Insights
Recurrent myocardial infarction is common, affecting over 40% of patients. Stress and personality are key risk factors for repeat heart attacks, while smoking cessation doesn't impact recurrence rates.
Area of Science:
- Cardiology
- Internal Medicine
- Epidemiology
Context:
- Acute myocardial infarction (AMI) relapse rates are significant, with over 40% of patients showing possible recurrence.
- A confirmed diagnosis of recurrent AMI was established in 12.5% of cases, with some experiencing a third event.
- Diagnostic challenges exist, as 27.7% of potential cases were dismissed due to inconclusive electrocardiographic data for transmural infarction.
Purpose:
- To investigate the frequency and characteristics of recurrent acute myocardial infarction.
- To analyze the evolution of risk factors in patients with coronary profiles.
- To compare symptoms, complications, morbidity, and mortality between first-time and recurrent AMI cases.
Summary:
- Clinical, enzymatic, and electrocardiographic evidence confirmed new transmural necrosis in evolving myocardial infarction.
- Thirty-eight hospital deaths (30.4%) occurred, with 25 undergoing necropsy.
- Recurrent myocardial infarction is 3.5 times more common in men than women, often occurring within the first year post-episode. Women experience first and recurrent AMIs at older ages.
Impact:
- Personality and stress are significant risk factors for recurrent infarction.
- While family history of ischemic heart disease is a risk factor for single MI, it's less influential in recurrent cases.
- Smoking cessation does not alter the frequency or mortality of recurrent myocardial infarction, despite its impact on first-time events.
Abstract:
1). In 1001 patients with acute myocardial infarction 403 cases were found (40.2%) showing possible relapse. A study was made of 125 cases (12.5%) with positive diagnosis of acute myocardial infarction relapse, and among them, 12 were found to be occurring for the third time. Is possible for the real frequency of the iterative infarction to be even higher, because many cases were dismissed (27.7%) for lacking of conclusive electrocardiographic data pointing to myocardial transmural infarction. 2). Investigations were conducted about the evolutive condition of the danger factors in the coronary profile as well in the male as in the female group. Besides, a comparative study was made about symptoms, complications, morbidity and mortality. Clinical, enzimatic and electrocardiographic proofs were found, in every case, of a new myocardial transmural necrosis which was in evolution, with waves of injury and ischemia. Thirty eight deaths were registered in hospitals (30.4%) and in 25 of these, a necropsic study was conducted. 3). This illness is more frequent among men than among women, in a 3.5 to 1 proportion. The recurrent myocardial necrosis tends to be more frequently present during the first year following the first episode. In women, the first myocardial infarction as well as the iterative infarction occur at an older age than in men. 4). The influence of personality and stress is a very important factor of danger in the iterative infarction. Familiar antecedents of ischemic cardiopathy constitute a danger factor in patients presenting a single episode of myocardial infarction; nevertheless they don't seem to have a determining influence in this group of relapsing infarction. Although this study confirms with statistics that smoking has a decisive influence in the first myocardial infarction, neither frequency nor mortality of the relapsing infarction are in any way modified by the diminishing or suppression of the smoking habit.