Alan S. Go, MD; Carlos Iribarren, MD, MPH, PhD; Malini Chandra, MS, MBA; Phenius V. Lathon; Stephen P. Fortmann, MD; Thomas Quertermous, MD; Mark A. Hlatky, MD; Atherosclerotic Disease, Vascular Function and Genetic Epidemiology (ADVANCE) Study
Grant Support: By the Donald W. Reynolds Foundation, Las Vegas, Nevada.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Alan S. Go, MD, Division of Research, Kaiser Permanente of Northern California, 2000 Broadway Street, 3rd Floor, Oakland, CA 94612-2304; e-mail, Alan.S.Go@kp.org.
Current Author Addresses: Drs. Go and Iribarren, Ms. Chandra, and Mr. Lathon: Division of Research, Kaiser Permanente of Northern California, 2000 Broadway Street, 3rd Floor, Oakland, CA 94612-2304.
Dr. Fortmann: Stanford Medical School, Hoover Pavillion, MD 5705, Stanford, CA 94305-5705.
Dr. Quertermous: Stanford University, Falk Building, 300 Pasteur Drive, Stanford, CA 94305.
Dr. Hlatky: Stanford University, HRP Redwood Building, Room 150, Stanford, CA 94305.
Author Contributions: Conception and design: A.S. Go, C. Iribarren, M. Chandra, S.P. Fortmann, T. Quertermous, M.A. Hlatky.
Analysis and interpretation of the data: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, M.A. Hlatky.
Drafting of the article: A.S. Go, M. Chandra, M.A. Hlatky.
Critical revision of the article for important intellectual content: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, T. Quertermous, M.A. Hlatky.
Final approval of the article: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, T. Quertermous, M.A. Hlatky.
Provision of study materials or patients: A.S. Go.
Statistical expertise: A.S. Go, M. Chandra, M.A. Hlatky.
Obtaining of funding: A.S. Go, C. Iribarren, S.P. Fortmann, T. Quertermous, M.A. Hlatky.
Administrative, technical, or logistic support: A.S. Go, M. Chandra, P.V. Lathon, T. Quertermous, M.A. Hlatky.
Collection and assembly of data: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, M.A. Hlatky.
Go AS, Iribarren C, Chandra M, Lathon PV, Fortmann SP, Quertermous T, et al. Statin and β-Blocker Therapy and the Initial Presentation of Coronary Heart Disease. Ann Intern Med. 2006;144:229-238. doi: 10.7326/0003-4819-144-4-200602210-00004
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Published: Ann Intern Med. 2006;144(4):229-238.
Acute myocardial infarction is believed to result from the acute rupture of a lipid-laden coronary atherosclerotic plaque, which in turn leads to acute thrombosis, cardiac ischemia, and subsequent myocardial necrosis (1). While many epidemiologic risk factors have been established to predict the development of any clinical manifestation of coronary heart disease (that is, acute myocardial infarction, unstable angina, or angina pectoris), most studies have not attempted to differentiate between unstable presentations, such as acute coronary syndromes, and more stable presentations of coronary disease, such as exertional angina. Thus, predictors of the development of plaque rupture and acute coronary events have not been well delineated. Previous studies have identified relatively few risk factors for acute myocardial infarction in patients with underlying coronary atherosclerosis. Among patients hospitalized with an acute coronary syndrome, those with acute myocardial infarction were less likely to have been taking aspirin before admission than those with unstable angina (2). Other clinical predictors of having an acute myocardial infarction compared with unstable angina included current smoking and absence of a previous diagnosis of hypertension (3).
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Cardiology, Coronary Heart Disease.
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