Identification of individuals at high risk for myocardial infarction.

The incidence of atherosclerotic coronary heart disease (CHD) was assessed in 4559 male participants of the Prospective Cardiovascular Münster (PROCAM) study, aged 40-64 years, over a 6 year follow-up period. In this time, 186 study participants developed atherosclerotic CHD (134 definite nonfatal myocardial infarctions and 52 definite atherosclerotic CAD deaths including 21 sudden cardiac deaths and 31 fatal myocardial infarctions). In multiple logistic function (MLF) analyses, age, cholesterol, HDL cholesterol, systolic blood pressure, and the binary (yes/no) criteria of cigarette smoking, angina pectoris, diabetes mellitus or hyperglycaemia, and family history of myocardial infarction showed a significant association with the incidence of atherosclerotic CHD after adjustment for the other risk factors. In the subgroup of individuals, in whom clotting factors were measured, fibrinogen was found to be an independent additional risk indicator for CHD by multiple logistic function analysis (P < 0.05). The relationship between a variable and total mortality or some of its components was described by dividing the patient series into quintiles of the studied variable and then calculating the age-standardized death rate for each quintile. Lowest risk of total mortality occurs in men with lowest risk of CHD, though relationships between total mortality and levels of single risk factors are 'J'-shaped or even 'U'-shaped.