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Biomedical subjects

D Elmfeldt

Publications and source records attributed to D Elmfeldt.

18 recordsLinked to original sources
PubMed1979

Influence of a myocardial infarction on blood pressure and serum cholesterol.

Blood pressure (BP) was measured before and after acute myocardial infarction (MI) in 21 men aged 49--60 years from a random population sample. Men on drugs affecting BP before MI or during follow-up were excluded. Pre- and postinfarction cholesterol levels were analyzed in 49 men not on hyperlipidemic treatment recruited from the same population sample. The mean fall in systolic BP (SBP) was 14 mmHg both five weeks and one year after the acute event, but 10 mmHg after two years. The mean fall in diastolic BP (DBP) was 10 mmHg five weeks after the MI and remained at this level for two years. The decreases in SBP and DBP were significant. There was a positive correlation between the maximum rise in SGOT during the acute phase of MI and the decrease in DBP between preinfarction readings and readings five weeks after the MI. Serum cholesterol was unchanged three months, and one and two years after the MI as compared to the preinfarction level.

Aged↗
PubMed1978

Hypertension and myocardial infarction.

In a representative series of male patients (n = 504) surviving the hospital stay of a first myocardial infarction the prevalence of hypertension and the influence of hypertension on the prognosis during 2 yr follow-up were studied. According to the definitions used hypertension had been detected before or was detected after myocardial infarction in 36% of the patients. Two thirds had a history of hypertension known before infarction. The systolic and diastolic blood pressures measured at 3 months and 1 yr after infarction increased with age. There was no difference between patients with and without hypertension with respect to a number of different variables recorded during the hospital period, nor in multiple risk according to a logistic function. There was no difference in death rate between the two groups. However, the rate of non-fatal reinfarction was significantly higher among the hypertensive patients. Hypertension remained as a risk factor for after myocardial infarction when the possible confounding influences of serum lipid levels and tobacco smoking were analysed.

Adult↗
PubMed1977

Prediction of cardiovascular deaths and non-fatal reinfarctions after myocardial infarction.

The present study concerns the development and validation of a logistic multivariate prognostic function in patients followed for two years after myocardial infarction. The patients studied constituted at least 90% of all cases in a total community--the City of Göteborg, Sweden. Using a multivariate logistic function with 7 variables, based on 30 cardiovascular deaths during two years after discharge from hospital among 292 men with first infarction, breathlessness at onset of symptoms of infarction, SGOT quartile, left heart failure, relative heart size, atrial fibrillation, a history of hypertension, and AV block recorded during the hospital phase were the most important variables. The first five of these variables made significant contributions (p less than 0.01) to the predictive power. The predictive capacity was confirmed in an independent series of 195 men with first infarction, among whom 17 cardiovascular deaths occurred. Around 60% of the total cardiovascular mortality was concentrated in the highest risk quintile. Deaths from non-cardiovascular causes were predicted less efficiently. Non-fatal recurrences could not be predicted by the present model. Thus, the function can predict the excess risk of mortality but not the excess risk of reinfarction during two years among men after an initial myocardial infarction.

Aspartate Aminotransferases↗
PubMed1977

Coffee consumption and coronary heart disease in middle-aged Swedish men.

The possible association between coffee and myocardial infarction (MI) has been studied both prospectively in a random population sample of Swedish men aged 50 years (n=834) and with case control methodology in non-selected male patients surviving a MI (age 40-57 years, n=230). Coffee consumption was significantly associated with two other important risk factors for MI, namely smoking and alcoholic intemperance, but weak (non-significant) relationships were found with serum cholesterol, serum triglycerides, systolic or diastolic BP, and dyspnoea on exertion. In the prospective study there was no significant relationship between coffee and MI, either with univariate or multivariate analysis. The retrospectively reported coffee consumption of MI patients was higher than of those who later suffered a MI (the population sample). With the aid of non-parametric multivariate analysis of the combined population sample and the series of MI patients, a significant association was found between coffee consumption and MI. The experience of having had a MI may have affected the patients' rating of coffee consumption, or their consumption may have really increased during some months or a few years before the MI.

Alcohol Drinking↗
PubMed1977

Angina pectoris and myocardial infarction.

Angina pectoris was studied in a representative series of male patients (n = 504) with a first myocardial infarction (MI) surviving the hospital stay. The prevalence of questionnaire angina before MI was 28% and of effort-induced chest pain alone 40%. Of the patients with effort-induced chest pain, 72% retained symptoms also after MI. No correlation with age was found. Three months after and one year after infarction the prevalence of effort-induced chest pain was 55% and 45%, respectively. The patients with effort-induced chest pain before MI had a somewhat more severe clinical course and a significantly higher death rate (15% versus 6%) than those without chest pain.

Adult↗
PubMed1976

Primary risk factors in patients with myocardial infarction.

A predicted probability of suffering myocardial infarction based on a multiple risk function involving serum cholesterol, systolic blood pressure, and tobacco consumption, was allocated retrospectively to 270 men who survived a primary myocardial infarction. The infarction patients were representative of all surviving, diagnosed cases of primary infarction in men in certain age groups in Göteborg, Sweden, during the years 1968-70. The patients were divided into three groups-low, moderate, and high risk. A large number of patients had suffered infarction despite relatively low risk, but the patients showed a tendency toward higher risk in comparison with the risk distribution in a representative population sample. In order to study whether other variables, not included in the risk function, could "explain" the infarction in patients with relatiely low risk, the different risk groups were compared. A high degree of mental stress, diabetes mellitus, and dyspnea on exertion, and possibly also raised triglycerides, contributed to "explain" the infarctions in the low-risk group. Low physical activity during leisure time was probably also of importance.

Aged↗
PubMed1976

Characteristics of representative male survivors of myocardial infarction compared with representative population samples.

A series of 299 men, aged 27-67, who had survived their first myocardial infarction (MI), have been compared with representative population samples with respect to tobacco consumption, alcoholic intemperance, physical activity during work and leisure time, occurrence of hypertension, and cholesterol and triglyceride levels in serum. The infarction patients comprised 90% of all surviving, diagnosed cases of primary MI in men aged 67 years or below during 1968-70 in Göteborg, Sweden. The comparison between infarction patients and general population samples revealed that the patients smoked more, and were less physically active during leisure time but not during work. They had more often a positive history of hypertension and treatment for high BP and their serum cholesterol and serum triglyceride values were higher. For all these variables the difference decreased with increasing age and was generally not statistically significant above the age of 60 years. Alcoholic intemperance was more common among infarction patients who died outside hospital, but there was no difference in this respect between surviving patients and the general population.

Adult↗
PubMed1976

Symptoms, disablement and treatment during two years after myocardial infarction.

Invalidism after myocardial infarction was elucidated by assessing chest pain, dyspnoea, need for cardiac medication, and the extent to which patients returned to work during the first two years after myocardial infarction. The patients in the study were obtained from the Myocardial Infarction Register in Göteborg and were followed at the Post-MI Clinic. Standardized criteria were used for handling of symptoms, signs, risk factors and complications. The prevalence of various symptoms was registered at regular intervals and the findings at 3 months and one year infarction are presented. The prevalence of symptoms was determined by means of questionnaires. Three months and one year after infarction the prevalence of effort-induced chest pain was 53 and 44%, respectively. There was no age correlation. The comparable figues for dyspnoea on exertion were 47 and 41%, respectively. The proportion of patients with dyspnoea tended to rise with increasing age. Dyspnoea on exertion was more prevalent at 3 months than at 12 months after infarction. About 60% of the patients had experienced some of the symptoms before acute infarction and this proportion increased to about 70% during the follow-up period. This rise is caused by an increase of patients with solitary dyspnoea. Only a few patients received treatment with digitalis and diuretics prior to onset of symptoms. Three and 12 months after infarction the prevalence of patients treated with digitalis was 36 and 39%, respectively. The corresponding figures for diuretics were 15 and 20%, respectively. Both digitalis and diuretic therapy were more frequent at 12 months than at 3 months after infarction. Diuretic therapy increased significantly with age. Three months after infarction 17% of the patients were back at work. After 12 and 24 months the corresponding figures were 63 and 70%, respectively. The tendency for resumption of work at all intervals during the follow-up decreased with advancing age. During the first year after myocardial infarction 30% of the patients were readmitted to hospital. The chief reason for readmission to hospital was suspected (but later not verified) reinfarction.

Adult↗
PubMed1975

Smoking and myocardial infarction.

In a representative series of male patients with primary myocardial infarction the prevalence of smokers prior to infarction was higher than in representative population samples. The difference decreased with increasing age, Those patients generally had a somewhat more severe clinical course than those who continued to smoke. Nevertheless, those who stopped had only half the rate of non-fatal recurrences (P smaller than 0.01) and half the cardiovascular mortality-rate (P smaller than 0.05) of those who continued to smoke.

Adult↗
PubMed1975

Deaths and non-fatal reinfarctions during two years' follow-up after myocardial infarction.

Since 1968 special units for registering and following up all myocardial infarction patients have been in operation in Góteborg. The present paper reports on the deaths and non-fatal reinfarctions among 440 men and women below 67 years of age followed for two years after hospitalization for myocardial infarction. Of the 359 men, 299 had their first infarction and 60 a recurrent infarction. During two years 13% of men with a first infarction, and 37% of men with a recurrent infarction died. Deaths were significantly more common during the first than during the second year. There was no significant difference in mortality between men and women. The incidence of non-fatal reinfarctions was of similar magnitude and showed similar time relationships. Two thirds of the deaths were sudden (within 24 hours after onset of new symptoms) and half of the deaths occurred outside hospital. The autopsy rate was 92%. Two thirds of the deaths were caused by a fresh morphological infarct. In one fourth of the deaths where no cause was found at autopsy, death was ascribed to malignant arrhythmias. Heart weights were higher among patients dying after recurrent infarction at entry to the study. No distinctive pattern was found when autopsy findings were correlated to the interval between the onset of symptoms and death. Deaths due to fresh infarction and without an identifiable cause were more common among those who died within 24 hours of onset of symptoms compared to those dying after longer intervals.

Adult↗
PubMed1975

A postmyocardial infarction clinic in Göteborg, Sweden. A follow-up of MI patients in a specialized out-patient clinic.

The registration of all myocardial infarctions (MI) in the city of Göteborg started on Jan. 1st 1968, when a special clinic was set up for ambulatory posthospital care of infarction patients. In 1970 this clinic was expanded to cover all patients below 67 years of age with MI in the city of Göteborg, the aim being to standardize and unify patient care and therapeutic regimens to provide opportunities for the study of patient characteristics, natural history, risk factors and effects of preventive measures. Results from such studies have been published, but so far no unified description of this special out-patient unit, nor of any similar unit elsewhere. Patient recruitment, considerations concerning personnel, patient education procedures and return visit routines are covered, together with investigative methods and criteria for the treatment of complications, symptoms and risk factors. The cumulative drop-out rate up to and including 2 years follow-up was only 3%. A brief bibliography of studies originating at the Postmyocardial Infarction Clinic is included.

Adult↗