Sex dependent risk factors for mortality after myocardial infarction: individual patient data meta-analysis

Hanna M. van Loo*, Edwin R. van den Heuvel, Robert A. Schoevers, Matteo Anselmino, Robert M. Carney, Johan Denollet, Frank Doyle, Kenneth E. Freedland, Sherry L. Grace, Seyed H. Hosseini, Kapil Parakh, Louise Pilote, Chiara Rafanelli, Annelieke M. Roest, Hiroshi Sato, Richard P. Steeds, Ronald C. Kessler, Peter de Jonge

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)
261 Downloads (Pure)

Abstract

Background: Although a number of risk factors are known to predict mortality within the first years after myocardial infarction, little is known about interactions between risk factors, whereas these could contribute to accurate differentiation of patients with higher and lower risk for mortality. This study explored the effect of interactions of risk factors on all-cause mortality in patients with myocardial infarction based on individual patient data meta-analysis.

Methods: Prospective data for 10,512 patients hospitalized for myocardial infarction were derived from 16 observational studies (MINDMAPS). Baseline measures included a broad set of risk factors for mortality such as age, sex, heart failure, diabetes, depression, and smoking. All two-way and three-way interactions of these risk factors were included in Lasso regression analyses to predict time-to-event related all-cause mortality. The effect of selected interactions was investigated with multilevel Cox regression models.

Results: Lasso regression selected five two-way interactions, of which four included sex. The addition of these interactions to multilevel Cox models suggested differential risk patterns for males and females. Younger women (age

Conclusions: Interactions of well-known risk factors for all-cause mortality after myocardial infarction suggested important sex differences. This study gives rise to a further exploration of prediction models to improve risk assessment for men and women after myocardial infarction.

Original languageEnglish
Article number242
Number of pages9
JournalBMC Medicine
Volume12
Issue number1
DOIs
Publication statusPublished - 17-Dec-2014

Keywords

  • All-cause mortality
  • Interactions
  • Myocardial infarction
  • Prediction
  • Risk factors
  • Sex
  • ACUTE CORONARY EVENTS
  • BODY-MASS INDEX
  • SYSTOLIC DYSFUNCTION
  • REGULARIZATION PATHS
  • COORDINATE DESCENT
  • POPULATION TRENDS
  • GLOBAL REGISTRY
  • AGE INTERACTION
  • HEART-FAILURE
  • DEPRESSION

Cite this