Mohammad Alidousti, Gholamreza Davoodi,
Volume 4, Issue 1 (7-2004)
Abstract
Background: Obesity is associated with many metabolic and cardiovascular diseases, for example, a direct and indirect relation has been established between obesity and diabetes, dyslipidemia, hypertension and atherosclerosis. But whether regional fat distribution contributes independently to risk remained unclear. This study was designed to determine relation between central obesity and acute myocardial infarction (AMI).
Methods: In this case-control study, body mass index (BMI) and waist to hip ratio (WHR) were calculated in 420 participants (140 cases and 280 controls). BMI and WHR means were evaluated in subgroups according to age, sex and cardiac risk factors. Odds ratio (95% CI) of the MI incidence in obese participants (BMI≥27 and/or WHR≥0.85) were compared with non obese subjects in each subgroups.
Results: Mean BMI mean in the case group (27.9±4.9) was more than control group (25.8±4.9) P≤0.05). The obese individuals had more chance of AMI (OR=3.2 CI=3-3.3). This chance increased with central obesity (OR=3.4 CI=3.2-3.6). Risk of AMI in younger obese participants (OR=4.3 CI=2.8-6.8) was more frequent than older ones (OR=2.1 CI=1.7-2.4). Central obesity increased risk of AMI in women (OR=3.6 CI=3.1-4.4) more than men (OR=2.2 CI=1.7-2.5).The excess risk of AMI in obese participants in associated with major cardiac risk factors was as following: hypertension (OR=18.4 CI=9.8-22.1), diabetes (OR=9 CI=4.2-14.1), hyperlipidemia (OR=6 CI=2.1-8.4), positive familial history (OR=2.6 CI=2.1-3.4) and smoking (OR=1.2 CI=0.9-1.7).
Conclusion: There is a strong association between BMI, WHR and risk of AMI. Central obesity comparing with general obesity has stronger relation with AMI incidence especially in women and younger subjects. In addition, cardiac risk factors except smoking aggravated correlation between obesity and AMI.
Reza Rajabian, Mohammad Khajedeluee, Afsoon Fazlinejad, Javad Rezazadeh,
Volume 4, Issue 4 (6-2005)
Abstract
Background: Myocardial infarction is the most important cause of mortality all over the world. Complications may increase with some risk factors including stress hyperglycemia. The aim of this study was to evaluate the correlation and importance of hyperglycemia in acute intrahospital complications after AMI.
Methods: Prevalence of stress hyperglycemia among 160 patients with acute myocardial infarction (Q wave MI) was determined. These patients were divided into normoglycemic and stress hyperglycemic groups. These were compared according to complications such as heart failure, cardiogenic shock and mortality.
Results: 61% were normoglycemic and 7.5% had stress hyperglycemia. 25% had history of diabetes and 4.4% were not aware of diabetes. Among 18 patients with stress hyperglycemia, 6 patient (50%) and among 101 normoglycemic patients 18 (17.8%) were affiliated with cardiac failure that the difference were significant (P=0.02 and χ 2= 6.25). There were no cases of cardiogenic shock in both groups. Three patients died during first hours of admission (2.97%). They hadn't have history of diabetes. We could not assign them to normoglycemic or stress hyperglycemic groups since blood sampling had not been done yet.
Conclusion: Stress hyperglycemia can increase complications of AMI, significantly stress hyperglycemia caused increased incidence of heart failure in this study.
