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Lifetime prediction of coronary heart disease and heart disease of uncertain etiology in a 50-year follow-up population study.
Int J Cardiol. 2015 Oct 01; 196:55-60.IJ

Abstract

OBJECTIVES

The relationships of four basic risk factors with 50-year incidence of coronary heart disease (CHD) and Heart Disease of Uncertain Etiology (HDUE) were investigated in a population study.

MATERIAL AND METHODS

There were 1712 men aged 40-59 years in 1960 and 1677, heart disease free, were followed-up for 50 years. Incidence of first event for CHD (sudden death, fatal and non-fatal myocardial infarction, other fatal and non-fatal coronary syndromes) and HDUE (heart failure, chronic arrhythmia, blocks, "chronic CHD", hypertensive heart disease) was estimated and the relationships of four basic risk factors analyzed.

RESULTS

In 50 years incidences of CHD and HDUE were respectively 26.9 and 20.6%. Cox proportional hazards models showed serum cholesterol as a strong CHD predictor (hazard ratio, HR, for 1 mmol/l difference 1.22 and confidence intervals, CI, 1.11 to 1.33), irrelevant for HDUE (HR 1.02 and CI 0.87 to 1.18). Age at entry was a stronger predictor for HDUE (HR for 5 year difference 1.65 and CI 1.46 to 1.86) than for CHD (HR 1.26 and CI 1.14 to 1.39). Systolic blood pressure and cigarette smoking had similar predictive power. The diagnosis of angina pectoris (AP) recorded at any time during the study was strongly associated with CHD but not with HDUE. A HDUE subgroup with AP had similar life-expectancy to CHD, suggesting the need to re-classify them as CHD.

CONCLUSIONS

Due to important differences in predictors (risk factors) and expectancy of life CHD and HDUE are probably manifestations of different etiologies.

Authors+Show Affiliations

Association for Cardiac Research, Rome, Italy.Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: paoloemilio.puddu@uniroma1.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26073214

Citation

Menotti, Alessandro, and Paolo Emilio Puddu. "Lifetime Prediction of Coronary Heart Disease and Heart Disease of Uncertain Etiology in a 50-year Follow-up Population Study." International Journal of Cardiology, vol. 196, 2015, pp. 55-60.
Menotti A, Puddu PE. Lifetime prediction of coronary heart disease and heart disease of uncertain etiology in a 50-year follow-up population study. Int J Cardiol. 2015;196:55-60.
Menotti, A., & Puddu, P. E. (2015). Lifetime prediction of coronary heart disease and heart disease of uncertain etiology in a 50-year follow-up population study. International Journal of Cardiology, 196, 55-60. https://doi.org/10.1016/j.ijcard.2015.05.151
Menotti A, Puddu PE. Lifetime Prediction of Coronary Heart Disease and Heart Disease of Uncertain Etiology in a 50-year Follow-up Population Study. Int J Cardiol. 2015 Oct 1;196:55-60. PubMed PMID: 26073214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lifetime prediction of coronary heart disease and heart disease of uncertain etiology in a 50-year follow-up population study. AU - Menotti,Alessandro, AU - Puddu,Paolo Emilio, Y1 - 2015/05/29/ PY - 2015/04/22/received PY - 2015/05/22/revised PY - 2015/05/26/accepted PY - 2015/6/16/entrez PY - 2015/6/16/pubmed PY - 2016/6/10/medline KW - 50-Year follow-up KW - Coronary heart disease KW - Etiology KW - Heart disease of uncertain etiology KW - Lifetime prediction SP - 55 EP - 60 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 196 N2 - OBJECTIVES: The relationships of four basic risk factors with 50-year incidence of coronary heart disease (CHD) and Heart Disease of Uncertain Etiology (HDUE) were investigated in a population study. MATERIAL AND METHODS: There were 1712 men aged 40-59 years in 1960 and 1677, heart disease free, were followed-up for 50 years. Incidence of first event for CHD (sudden death, fatal and non-fatal myocardial infarction, other fatal and non-fatal coronary syndromes) and HDUE (heart failure, chronic arrhythmia, blocks, "chronic CHD", hypertensive heart disease) was estimated and the relationships of four basic risk factors analyzed. RESULTS: In 50 years incidences of CHD and HDUE were respectively 26.9 and 20.6%. Cox proportional hazards models showed serum cholesterol as a strong CHD predictor (hazard ratio, HR, for 1 mmol/l difference 1.22 and confidence intervals, CI, 1.11 to 1.33), irrelevant for HDUE (HR 1.02 and CI 0.87 to 1.18). Age at entry was a stronger predictor for HDUE (HR for 5 year difference 1.65 and CI 1.46 to 1.86) than for CHD (HR 1.26 and CI 1.14 to 1.39). Systolic blood pressure and cigarette smoking had similar predictive power. The diagnosis of angina pectoris (AP) recorded at any time during the study was strongly associated with CHD but not with HDUE. A HDUE subgroup with AP had similar life-expectancy to CHD, suggesting the need to re-classify them as CHD. CONCLUSIONS: Due to important differences in predictors (risk factors) and expectancy of life CHD and HDUE are probably manifestations of different etiologies. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/26073214/Lifetime_prediction_of_coronary_heart_disease_and_heart_disease_of_uncertain_etiology_in_a_50_year_follow_up_population_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(15)01235-8 DB - PRIME DP - Unbound Medicine ER -