Triggers of acute myocardial infarction: a neglected piece of the puzzle.
The existence of specific risk factors for the development of coronary heart disease, both chronic and acute, has been extensively investigated and is well understood by cardiology professionals. Diabetes, hypertension, hypercholesterolemia, psychological patterns and smoking are assumed to interact in a complex way with individual heritable predisposition, thus determining the long-term probability of coronary disease. However, the possibility that defined circumstances and activities may act as immediate triggers of acute coronary syndromes, particularly acute myocardial infarction, has not been given comparable attention in clinical research. For example, the recently issued 2012 European guidelines on cardiovascular disease prevention completely overlook the topic of triggers and their possible prevention. This review presents a picture of the most reliable evidence regarding the triggering of myocardial infarction and contributes to further investigation in the field.
aCardiology Department, 'Luigi Sacco' Hospital, Milano, Italy bCardiology Division, University Hospital Centre, Split, Croatia cMaccabi Healthcare Services, Tel Aviv, Israel.
Alessandro
A
Colombo
Riccardo
R
Proietti
Viktor
V
Culić
Nestor
N
Lipovetzky
Maurizio
M
Viecca
Paolo
P
Danna
D000203:Activities of Daily Living; D006801:Humans; D008019:Life Style; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior