Introduction. Residents of Kazakhstan have a higher incidence rate and a younger age of onset of acute myocardial infarction (AMI) compared to Western populations. The risk factors for the development of recurrent AMI in Kazakhstan were not investigated yet.
The objective of the study was to analyse the risk factors for the development of recurrent AMI in patients of the Kazakh population.
Material and methods. The study included 185 patients with AMI less than 59 years old, registered in the polyclinics of Nur-Sultan city. Clinical characteristics, biochemical data, echocardiography, cardiac surgical interventions, and outcomes were collected and analysed. Multivariate logistic regression was performed to assess the association between risk factors for recurrent AMI, adjusted for other confounding variables.
Results. 153 patients with a history of AMI were selected. Of these, 16 (10.4%) patients with recurrent AMI, and 137 (89.6%) without a history of recurrent AMI. The distribution by gender in the group without recurrent AMI: 127 (92.7%) men and 10 (7.3%) women, while in the group with recurrent AMI there were only men, 16 (100.0%), p = 0.54. Multiple logistic regression revealed 8 variables independently associated with the risk of recurrent AMI. The relationship between the risk of developing recurrent AMI in males was determined: OR 1.972 (95% CI: 3.2-7.9). An association with the risk of recurrent AMI was also determined, such as smoking (OR 5.374; 95% CI: 0.2-21.5) and alcohol consumption (OR 2.099; 95% CI: 2.8-8.4), p = 0.001 and p = 0.05, respectively. The level of triglycerides (TG) associated with the risk of recurrent AMI: OR 3.19 (95% CI: 0.1-12.7), p = 0.01. In addition, HDL-cholesterol (OR 3.85; 95% CI: 4.9-15.4) and blood glucose levels (OR 3.19; 95% CI: 1.4-12.7), p = 0.001 and p = 0.01, respectively. The presence of arrhythmia also increased the risk of recurrent AMI (OR 1.27; 95% CI: 3.2-5.1), p = 0.05.
Conclusions. The findings indicate the association between AMI and factors such as male gender, smoking, alcohol abuse, high TG and blood glucose levels, and the presence of arrhythmia. Our data showed that patients of the Kazakh population who had a history of AMI with the indicated risk factors need more intensive treatment and preventive measures aimed at reducing modifiable risk factors.
Keywords: cardiovascular disease, myocardial infarction, risk factors, gender, Kazakhstan.
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