Background
Methods
Data sources and study sample
Predictor of interest
Independent variable/outcome of interest
Study covariates and confounders
Statistical analyses
Results
All episodes | Myocardial infarction during follow-up | p value | ||
---|---|---|---|---|
No | Yes | |||
Total, N | 1,733,613a | 1,719,334 | 14,279 | |
Age, mean (SD) | 75.3 (7.6) | 75.3 (7.6) | 77.0 (7.4) | < 0.0001 |
Gender, N (%) | < 0.0001 | |||
Male | 734,540 (42.4%) | 727,667 (42.3%) | 6873 (48.1%) | |
Female | 999,073 (57.6%) | 991,667 (57.7%) | 7406 (51.9%) | |
Race/ethnicity, N (%) | 0.18 | |||
White | 1,493,475 (86.1%) | 1,481,232 (86.2%) | 12,243 (85.7%) | |
Black | 142,284 (8.2%) | 141,052 (8.2%) | 1232 (8.6%) | |
Other/unknown | 97,854 (5.6%) | 97,050 (5.6%) | 804 (5.6%) | |
Charlson–Romano comorbidity score | ||||
0 | 913,332 (52.7%) | 909,183 (52.9%) | 4149 (29.1%) | < 0.0001 |
1 | 174,551 (10.1%) | 172,711 (10.0%) | 1840 (12.9%) | |
≥ 2 | 645,730 (37.2%) | 637,440 (37.1%) | 8290 (58.1%) | |
Charlson–Romano comorbidity score, mean (SD) | 1.60 (2.39) | 1.59 (2.38) | 2.71 (2.79) | < 0.0001 |
Charlson–Romano comorbidities | ||||
Myocardial infarctionb | 65,668 (3.8%) | 64,977 (3.8%) | 0 (0%) | < 0.0001 |
Heart failure | 202,190 (11.7%) | 199,011 (11.6%) | 3179 (22.3%) | < 0.0001 |
Peripheral vascular disease | 168,646 (9.7%) | 165,601 (9.6%) | 3045 (21.3%) | < 0.0001 |
Cerebrovascular disease | 168,696 (9.7%) | 166,159 (9.7%) | 2537 (17.8%) | < 0.0001 |
Dementia | 78,238 (4.5%) | 77,698 (4.5%) | 540 (3.8%) | < 0.0001 |
Chronic pulmonary disease | 270,419 (15.6%) | 267,014 (15.5%) | 3405 (23.8%) | < 0.0001 |
Connective tissue disease | 48,195 (2.8%) | 47,571 (2.8%) | 624 (4.4%) | < 0.0001 |
Peptic ulcer disease | 32,778 (1.9%) | 32,371 (1.9%) | 407 (2.9%) | < 0.0001 |
Mild liver disease | 8543 (0.49%) | 8472 (0.49%) | 71 (0.50%) | 0.94 |
Diabetes | 319,836 (18.4%) | 314,635 (18.3%) | 5201 (36.4%) | < 0.0001 |
Diabetes with end organ damage | 94,249 (5.4%) | 92,168 (5.4%) | 2081 (14.6%) | < 0.0001 |
Hemiplegia | 14,339 (0.83%) | 14,164 (0.82%) | 175 (1.2%) | < 0.0001 |
Renal failure/disease | 59,280 (3.4%) | 58,007 (3.4%) | 1273 (8.9%) | < 0.0001 |
Any tumor, leukemia, or lymphoma | 174,684 (10.1%) | 172,971 (10.1%) | 1713 (12.0%) | < 0.0001 |
Moderate or severe liver disease | 2002 (0.12%) | 1986 (0.12%) | 16 (0.11%) | 0.9 |
Metastatic cancer | 18,009 (1.0%) | 17,895 (1.0%) | 114 (0.80%) | 0.004 |
AIDS | 549 (0.03%) | 543 (0.03%) | 6 (0.04%) | 0.49 |
Hypertension | 836,875 (48.3%) | 827,183 (48.1%) | 9692 (67.9%) | < 0.0001 |
Hyperlipidemia | 602,546 (34.8%) | 595,936 (34.7%) | 6610 (46.3%) | < 0.0001 |
Coronary artery disease | 302,088 (17.4%) | 297,025 (17.3%) | 5063 (35.5%) | < 0.0001 |
Obesity | 36,034 (2.1%) | 35,602 (2.1%) | 432 (3.0%) | < 0.0001 |
Multivariable-adjusteda model 1 | Multivariable-adjusteda model 2 | Multivariable-adjusteda model 3 | ||||
---|---|---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | |
Age (years) | ||||||
65 to < 75 | Ref | Ref | Ref | |||
75 to < 85 |
1.62 (1.56, 1.68)
|
< 0.0001
|
1.60 (1.54, 1.66)
|
< 0.0001
|
1.55 (1.49, 1.61)
|
< 0.0001
|
≥ 85 |
2.51 (2.39, 2.64)
|
< 0.0001
|
2.52 (2.39, 2.64)
|
< 0.0001
|
2.47 (2.35, 2.60)
|
< 0.0001
|
Gender | ||||||
Male | Ref | Ref | Ref | |||
Female |
0.75 (0.73, 0.78)
|
< 0.0001
|
0.74 (0.72, 0.77)
|
< 0.0001
|
0.76 (0.74, 0.79)
|
< 0.0001
|
Race | ||||||
White | Ref | Ref | Ref | |||
Black | 1.00 (0.94, 1.06) | 0.97 | 1.05 (0.99, 1.11) | 0.10 | 0.95 (0.90, 1.01) | 0.11 |
Other |
0.93 (0.86, 1.00)
|
0.038
| 0.97 (0.90, 1.04) | 0.35 |
0.89 (0.83, 0.96)
|
0.002
|
Charlson–Romano score, per unit change |
1.21 (1.21, 1.22)
|
< 0.0001
| N/A | N/A | ||
Charlson–Romano comorbidity score, N (%) | ||||||
0 | N/A | Ref | N/A | |||
1 |
2.20 (2.08, 2.33)
|
< 0.0001
| ||||
≥ 2 |
3.11 (2.99, 3.23)
|
< 0.0001
| ||||
Gout |
2.08 (1.95, 2.21)
|
< 0.0001
|
2.14 (2.01, 2.27)
|
< 0.0001
|
1.79 (1.68, 1.90)
|
< 0.0001
|
Multivariable-adjusted model 1 | Multivariable-adjusted model 1 | Multivariable-adjusted model 1 | ||||
---|---|---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | |
Black | White | Other race | ||||
Gout |
2.49 (2.10, 2.96)
|
< 0.0001
|
2.02 (1.89, 2.16)
|
< 0.0001
|
2.05 (1.59, 2.65)
|
< 0.0001
|
Female | Male | |||||
Gout |
2.13 (1.94, 2.35)
|
< 0.0001
|
2.04 (1.89, 2.21)
|
< 0.0001
| ||
Age 65–75 years | Age 75–85 years | Age > 85 years | ||||
Gout |
2.09 (1.90, 2.31)
|
< 0.0001
|
1.89 (1.73, 2.08)
|
< 0.0001
|
2.50 (2.15, 2.91)
|
< 0.0001
|
No hypertension | Hypertension | |||||
Gout |
3.00 (2.65, 3.40)
|
< 0.0001
|
1.73 (1.61, 1.85)
|
< 0.0001
| ||
No diabetes | Diabetes | |||||
Gout |
2.35 (2.17, 2.55)
|
< 0.0001
|
1.64 (1.49, 1.80)
|
< 0.0001
| ||
No hyperlipidemia | Hyperlipidemia | |||||
Gout |
2.45 (2.24, 2.69)
|
< 0.0001
|
1.74 (1.60, 1.90)
|
< 0.0001
| ||
No heart failure | Heart failure | |||||
Gout |
2.20 (2.04, 2.36)
|
< 0.0001
|
1.73 (1.55, 1.93)
|
< 0.0001
| ||
No CAD | CAD | |||||
Gout |
2.18 (2.01, 2.37)
|
< 0.0001
|
1.74 (1.59, 1.91)
|
< 0.0001
|