WEDNESDAY, Nov. 16 (HealthDay News) -- Although the majority of patients presenting with initial myocardial infarction (MI) have one or more coronary heart disease (CHD) risk factors, in-hospital mortality in these patients is inversely correlated with the number of risk factors, according to a study published in the cardiovascular disease-themed Nov. 16 issue of the Journal of the American Medical Association to coincide with presentation at the American Heart Association's Scientific Sessions 2011, held from Nov. 12 to 16 in Orlando, Fla.
John G. Canto, M.D., M.S.P.H., from the Watson Clinic in Lakeland, Fla., and colleagues examined the correlation between the number of CHD risk factors and in-hospital mortality in 542,008 patients with first MI without prior cardiovascular disease. Data were collected from the U.S. National Registry of MI from 1994 to 2006, and analyzed to estimate all-cause in-hospital mortality.
The investigators found that 85.6 percent of participants had at least one CHD risk factor, while 14.4 percent had none. There was a significant inverse correlation between age and the number of risk factors, with patients with a mean age of 71.5 years having zero risk factors and those with a mean age of 56.7 years having five risk factors. There were 50,788 in-hospital deaths from all-causes. Participants with zero to five risk factors had unadjusted in-hospital mortality of 14.9, 10.9, 7.9, 5.3, 4.2 and 3.6 percent, respectively. After adjusting for age and other clinical factors, the number of risk factors correlated inversely with hospital mortality (adjusted odds ratio, 1.54), consistently across several age and patient subgroups.
"We found that hospital mortality increased consistently as the number of risk factors declined," the authors write.
Several of the study authors disclosed financial relationships with pharmaceutical companies, including Genentech Inc., which funded the National Registry of MI.
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