Abstract 16110: Impact of Asthma Status on Risk of Incident Myocardial Infarction: A population-Based Case-Control Study
Background: Although asthma and coronary heart disease are considered among the five most burdensome diseases in the US, little is known about the relationship between asthma and risk of myocardial infarction (MI). Our aim was to determine whether asthma or other atopic conditions are associated with risk of MI.
Method: The study was designed as a population-based retrospective case-control study, which included 693 Olmsted County, MN residents who developed MI between Nov 1, 2002 and May 31, 2006. We identified 1:1 age-, gender- and residency-matched controls. MI was defined using standardized criteria including 1) chest pain, 2) electrocardiographic data using Minnesota coding, and 3) cardiac enzyme levels (cutoff value of cardiac troponin T used at Mayo Clinic; ≥ 0.03 ng/mL). Asthma status was ascertained using predetermined criteria for asthma. Active asthma was defined as the presence of asthma symptoms, use of asthma medications, and unscheduled medical visits for asthma within one year prior to MI index date.
Results: Of the 693 MI cases, 543 were eligible for this study of whom 240 (44 %) were females and the mean age was 67.5 years. Of the 543 MI case, 81(15 %) had a history of asthma prior to index date of MI whereas 52 of 543 controls (10%) had such a history (adjusted OR: 1.36; 95% CI: 0.85-2.17; p=0.195), controlling for all significant comorbid conditions including COPD. When we re-fit this multivariable model without the COPD covariate, asthma was significantly associated with an increased risk of MI (adjusted OR: 1.69, 95% CI 1.07-2.67, p=0.024). In the subgroup of asthmatics (n=133), the odds of MI were two-fold higher in those asthma was active (vs. inactive) at the index date, controlling for the matching factors (adjusted OR 2.09, 95% CI 1.01-4.31, p=0.047).
Conclusion: Asthma, especially active asthma, was associated with an increased risk of MI, when the association was not controlled for COPD. Given the known overlap between asthma and COPD and association of COPD with the risk of MI, clinicians need to discern and address the increased risk of MI among subgroups of asthmatics with active asthma and/or clinical features of COPD.
Author Disclosures: D. Bang: None. E. Kim: None. C. Wi: None. J. Hagan: None. V. Roger: None. S. Manemann: None. B. Lahr: None. Y. Juhn: None.
- © 2014 by American Heart Association, Inc.