Infarto agudo do miocárdio. Primeira manifestação da cardiopatia isquêmica e relação com fatores de risco / Acute myocardial infarction. The first manifestation of ischemic heart disease and relation to risk factors

RESUMO

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 percent were males, 90.4 percent were white, 73.1 percent were older than 55 years, and 53.8 percent were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49 percent of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95 percent CI=0.06-0.59; P=0.04) and left ventricular hypertrophy (RR=0.27; 95 percent CI=0,.8-0.88; P=0.03). The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50 percent. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels