{
 "id": "0ae2dfe1-b4f1-4098-8f4a-3b23038c29f9",
 "disease": {
  "id": "H01730",
  "names": [
   "Myocardial infarction"
  ],
  "dbLinks": {
   "icd10": [
    "I21"
   ],
   "mesh": [
    "D009203"
   ]
  },
  "category": "Cardiovascular disease"
 },
 "article": {
  "id": "10080459",
  "text": "OBJECTIVE:\nTo assess the relationship between dysglycemia and myocardial infarction in nondiabetic individuals.\n\nBACKGROUND:\nNondiabetic hyperglycemia may be an important cardiac risk factor. The relationship between myocardial infarction and glucose, insulin, abdominal obesity, lipids and hypertension was therefore studied in South Asians-a group at high risk for coronary heart disease and diabetes.\n\nMETHODS:\nDemographics, waist/hip ratio, fasting blood glucose (FBG), insulin, lipids and glucose tolerance were measured in 300 consecutive patients with a first myocardial infarction and 300 matched controls.\n\nRESULTS:\nCases were more likely to have diabetes (OR 5.49; 95% CI 3.34, 9.01), impaired glucose tolerance (OR 4.08; 95% CI 2.31, 7.20) or impaired fasting glucose (OR 3.22; 95% CI 1.51, 6.85) than controls. Cases were 3.4 (95% CI 1.9, 5.8) and 6.0 (95% CI 3.3, 10.9) times more likely to have an FBG in the third and fourth quartile (5.2-6.3 and \u003e6.3 mmol/1); after removing subjects with diabetes, impaired glucose tolerance and impaired fasting glucose, cases were 2.7 times (95% CI 1.5-4.8) more likely to have an FBG \u003e5.2 mmol/l. A fasting glucose of 4.9 mmol/l best distinguished cases from controls (OR 3.42; 95% CI 2.42, 4.83). Glucose, abdominal obesity, lipids, hypertension and smoking were independent multivariate risk factors for myocardial infarction. In subjects without glucose intolerance, a 1.2 mmol/l (21 mg/dl) increase in postprandial glucose was independently associated with an increase in the odds of a myocardial infarction of 1.58 (95% CI 1.18, 2.12).\n\nCONCLUSIONS:\nA moderately elevated glucose level is a continuous risk factor for MI in nondiabetic South Asians with either normal or impaired glucose tolerance."
 },
 "questions": [
  {
   "id": "7a353a7a-9da9-43b1-93e4-e4852d0fb260",
   "text": "What are the risk factors of Myocardial infarction?",
   "answers": [
    {
     "answer_start": 1610,
     "text": "moderately elevated glucose level"
    },
    {
     "answer_start": 1260,
     "text": "abdominal obesity"
    },
    {
     "answer_start": 1279,
     "text": "lipids"
    },
    {
     "answer_start": 1287,
     "text": "hypertension"
    },
    {
     "answer_start": 1304,
     "text": "smoking"
    }
   ]
  }
 ]
}