Biomedical subjects

A Nobili

Publications and source records attributed to A Nobili.

12 recordsLinked to original sources

PubMed1992

Body mass and acute myocardial infarction. GISSI-EFRIM Investigators.

BACKGROUND: The relation between body mass index and acute myocardial infarction was analyzed using data from a multicentric case-control study conducted in Italy between September 1988 and June 1989 within the framework of the GISSI-2 trial. METHODS: Subjects were 916 patients with acute myocardial infarction and no history of cardiovascular disease and 1,106 controls hospitalized for acute conditions not related to known or suspected risk factors for ischaemic heart disease. RESULTS: Relative to the lowest quintile of the Quetelet Index (weight/height2) the estimated risks for subsequent quintiles were 1.2 (95% confidence intervals, (CI): 0.9 to 1.6), 1.7 (95% CI: 1.2 to 2.2), 1.8 (95% CI: 1.4 to 2.4), and 2.2 (95% CI: 1.7 to 3.0) when adjustment was made for age, sex, education, and smoking habits by means of logistic regression. The association was consistent across strata of sex, education, and smoking status, but not age. The estimated risk for subjects in the fifth quintile of the Quetelet Index relative to those in the first was 4.1 under 55 years of age, but only 1.7 between 55 and 64 years and 1.5 above age 65. CONCLUSION: The relation between body mass and myocardial infarction was explained, at least in part, by higher serum cholesterol levels and the prevalence of diabetes and hypertension among fatter subjects. This does not, however, totally eclipse a possible causal relation between body mass and risk of myocardial infarction, since these conditions are a consequence, rather than a confounder, of overweight.

Adult↗

PubMed1992

Role of family history in patients with myocardial infarction. An Italian case-control study. GISSI-EFRIM Investigators.

BACKGROUND: A family history of heart disease has been reported to increase the risk of coronary heart disease. We examined the relation between family history of myocardial infarction (MI) and risk of acute MI to establish the independency of this association, the degree of risk in relation to the number and age of relatives affected, and the possible interaction between family history and other major risk factors for MI. METHODS AND RESULTS: In a case-control study conducted in Italy within the framework of the GISSI-2 Trial, 916 cases of newly diagnosed MI and 1,106 hospital controls were identified. Using a structured questionnaire, data were collected on the history of MI in first-degree relatives and the age at which the event occurred. Compared with subjects without family history of MI in first-degree relatives, the relative risk (RR) of MI was 2.0 (95% confidence interval, CI, 1.6-2.5) in those with one and 3.0 (95% CI, 2.0-4.4) in those with two or more relatives affected (chi 2(1) test for trend, 54.1; p less than 0.001). Such an increase was not substantially affected by allowance for recognized risk factors. The risk related to family history involving at least two relatives was higher for early MI (less than 55 years) (RR, 20.0; 95% CI, 3.3-121.2) compared with later MI (less than or equal to 65 years) (RR, 3.5; 95% CI, 1.8-6.6). When known risk factors were considered for their interaction with family history, the effect on RR was approximately multiplicative for several variables, including smoking, serum cholesterol, hypertension, and hyperlipidemia but not for diabetes and body mass index. Thus, the presence of both family history and smoking and cholesterol levels greater than or equal to 226 mg/dl led to an RR of 14 (95% CI, 3.7-50.0) and 8.3 (95% CI, 1.8-38.7), respectively. CONCLUSIONS: This study indicates that a family history of MI is an independent risk factor for MI, and that the number of relatives and the age at which they were affected is related to the strength of the association. There is a multiplicative effect on RR between family history and several major risk factors for MI.

Case-Control Studies↗

PubMed1988