Deck 4: Epidemiology of Myocardial Infarction

Question 1

Myocardial infarctions (MI) are most commonly due to occlusion (blockage) of a coronary artery caused by atherosclerosis or following the rupture of a vulnerable atherosclerotic plaque.

Answer 1

True

Question 2

Myocardial infarctions cause 7.2 million deaths annually in the world population.

Answer 2

True

Question 3

Approximately 75% of deaths from MI occur in the populations of developing nations, typically at relatively early ages (median age $\approx$ 50 years).

Answer 3

True

Question 4

Approximately 25% of deaths from MI occur in populations of developed nations, typically at later ages (median age $\approx$ 65 years).

Question 5

The global pattern of Disability Adjusted Life Years (DALY) for MI is similar to that for coronary heart disease.

Question 6

The case fatality rate for MI is highest in developing nations.

Question 7

Case fatality from MI has declined markedly in developed nations in recent years.

Question 8

The incidence of MI has declined dramatically in the US population.

Question 9

The mortality due to MI has declined dramatically in the US population.

Question 10

Based on results of the INTERHEART Study, the best predictive risk factor for MI is the Apo B / Apo A1 ratio.

Question 11

What percentage of myocardial infarctions occur without warning in the absence of prior chest pain or other symptoms?

A) 10%
B) 15%
C) 20%
D) 25%

Question 12

The case fatality of MI in developing nations is approximately:

A) 50%.
B) 60%.
C) 70%.
D) 80%.

Question 13

The case fatality of MI in developed nations is approximately:

A) 30%.
B) 40%.
C) 50%.
D) 60%.

Question 14

The case fatality of MI in the US population is currently approximately:

A) 10%.
B) 20%.
C) 30%.
D) 40%.

Question 15

What biomarker of inflammation has recently proven to be an effective predictor of impending MI?

A) Apo B / Apo A1 ratio
B) C Reactive Protein
C) HDL cholesterol
D) LDL cholesterol

Question 16

Based on results from the INTERHEART Study, which of the following is the strongest risk factor for MI?

A) Apo B / Apo A1 ratio
B) Chronic smoking
C) Alcohol abuse
D) High LDL cholesterol

Question 17

Which of the following statements best fits the current evidence regarding estrogen replacement therapy in postmenopausal women?

A) ERT increases the risk of endometrial cancer.
B) ERT increases the risk of breast cancer.
C) ERT initiated in older women increases the risk of MI.
D) All statements are correct.
E) Only a and c are correct.

Question 18

Which ethnic group has the highest incidence of MI?

A) African Americans
B) Hispanic Americans
C) Non-Hispanic Caucasian Americans
D) The incidence rates for all ethnicities are similar.

Question 19

In the INTERHEART Study, what measure of obesity was the strongest predictor of acute MI?

A) Elevated Waist to Hip Ratio
B) BMI > 25
C) BMI > 30
D) BMI > 35

Question 20

Which of the following blood levels do not increase MI risk?

A) Elevated Homocysteine
B) Elevated APO A1
C) Elevated APO B
D) Elevated C Reactive Protein
E) Elevated Glucose

Question 21

Briefly discuss the basic anatomy and function of the human heart.

Question 22

Describe signs, symptoms, and clinical parameters of myocardial infarction.

Question 23

Discuss the global burden of myocardial infarction.

Question 24

Discuss key findings of the INTERHEART Study.

Question 25

Discuss both acute and chronic factors that influence the risk of MI.

Question 26

Why have mortality and case fatality from MI declined sharply in the US population in recent years?

Question 27

Discuss findings of studies of selective cyclooxygenase 2 (COX-2) inhibitors and MI risk.

Question 28

What strategies would you propose for the primary, secondary, and tertiary prevention of MI?