title: Acute myocardial infarction: the first manifestation of ischemic heart disease and relation to risk factors.
abstract: OBJECTIVE
  To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings.
  
  
  METHODS
  We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed.
  
  
  RESULTS
  Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04) and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03). The remaining risk factors were not statistically significant.
  
  
  CONCLUSIONS
  Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, RS, Brazil.
authors.forename: Waldomiro Carlos
authors.initials: WC
authors.lastname: Manfroi
authors.forename: Carolina
authors.initials: C
authors.lastname: Peukert
authors.forename: Clarissa Bacha
authors.initials: CB
authors.lastname: Berti
authors.forename: Clarissa
authors.initials: C
authors.lastname: Noer
authors.forename: Danielle de Avila
authors.initials: Dde A
authors.lastname: Gutierres
authors.forename: Felipe Theodoro Bezerra Gaspar Carvalho da
authors.initials: FT
authors.lastname: Silva
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D017202:Myocardial Ischemia / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors