Population Health Research Institute
Study List

INTERHEART (Completed)
A Global Study of Risk Factors for Acute Myocardial Infarction

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The INTERHEART study found that nine easily measurable and modifiable risk factors could explain over 90 per cent of the risk of a heart attack globally and in all regions and major ethnic groups of the world. These studies emphasized that avoidance of tobacco, daily consumption of fruits and vegetables and regular exercise could potentially avoid two-thirds of heart disease. The results also indicated that tobacco (smoking even one cigarette per day increases the risk of myocardial infarction (MI) by five per cent) and abnormal lipids were the two most important risk factors globally, and that the markers of abdominal obesity and hip size (waist-to-hip-ratio) are far more predictive than body mass index (BMI) in predicting MI. Furthermore, stress and psychosocial factors were found to be important risk factors for MI.

Study Design: Observational Study.

Intervention: N/A.

Length of Study: 6 years

# of Patients: 29,972

Patient Populations: Survivors of first recent MI were compared to age and sex matched controls.


Rosengren Interheart Psychosocial

Yusuf Global Relevance Symposium

Main Publications (for a full listing of publications, please visit the 'Media and Publications' section)

INTERHEART, Am Heart Journal, 2001; 141:711-721: Stephanie Ôunpuu, PhD, Abdissa Negassa, PhD, and Salim Yusuf, DPhil, FRCPC, for the INTER-HEART Investigators

INTERHEART Risk Factors, Lancet, 2004 Sep 11-17;364(9438):937-52: Salim Yusuf, Steven Hawken, Stephanie Ôunpuu, Tony Dans, Alvaro Avezum, Fernando Lanas, Matthew McQueen, Andrzej Budaj, Prem Pais, John Varigos, Liu Lisheng, on behalf of the INTERHEART Study Investigators

INTERHEART Psychosocial, Lancet, 2004 Sep 11-17;364(9438):953-62.: Annika Rosengren, Steven Hawken, Stephanie Ôunpuu, Karen Sliwa, Mohammad Zubaid, Wael A Almahmeed, Kathleen Ngu Blackett, Chitr Sitthi-amorn, Hiroshi Sato, Salim Yusuf, for the INTERHEART investigators*

INTERHEART Obesity, Lancet, 2005; 366:1640-1649 : Salim Yusuf, Steven Hawken, Stephanie Ôunpuu, Leonelo Bautista, Maria Grazia Franzosi, Patrick Commerford, Chim C Lang, Zvonko Rumboldt, Churchill L Onen, Liu Lisheng, Supachai Tanomsup, Paul Wangai Jr, Fahad Razak, Arya M Sharma, Sonia S Anand, on behalf of the INTERHEART Study Investigators*

IHAfricaStudy, Circulation 2005; 112:3554-3561: Krisela Steyn, MD; Karen Sliwa, MD; Steven Hawken, MSc; Patrick Commerford, FCP(SA); Churchill Onen, FRCP(Lond); Albertino Damasceno, MD, PhD; Stephanie Ounpuu, PhD; Salim Yusuf, DPhil, FRCP; for the INTERHEART Investigators in Africa

INTERHEART Tobacco, Lancet, 2006; 368:647-658: Koon K Teo, Stephanie Ounpuu, Steven Hawken, MR Pandey, Vicent Valentin, David Hunt, Rafael Diaz, Wafa Rashed, Rosario Freeman, Lixin Jiang, Xiaofei Zhang, Salim Yusuf, on behalf of the INTERHEART Study Investigators

INTERHEART South Asia, JAMA 2007; 297:286-294: Prashant Joshi, MD, Shofiqul Islam, MSc, Prem Pais, MD Srinath Reddy, MD, Prabhakaran Dorairaj, MD, Khawar Kazmi, MBBS, Mrigendra Raj Pandey, MBBS Sirajul Haque, MBBS, Shanthi Mendis, MD, Sumathy Rangarajan, MSc, Salim Yusuf, MD, DPhil

INTERHEART Latin America, Circulation 2007; 115:1067-1074: Fernando Lanas, MSc, MD; Alvaro Avezum, MD, PhD; Leonelo E. Bautista, MD, DrPH; Rafael Diaz, MD; Max Luna, MD; Shofiqul Islam, MSc; Salim Yusuf, DPhil, FRCP; for the INTERHEART Investigators in Latin America

INTERHEART Women's, European Heart Journal, 2008 Apr;29(7):932-40 : Sonia S. Anand, Shofiqul Islam, Annika Rosengren, Maria Grazia Franzosi, Krisela Steyn, Hussein Yusufali Afzal, Matyas Keltai, Rafael Diaz, Sumathy Rangarajan, and Salim Yusuf on behalf of the INTERHEART INVESTIGATORS

INTERHEART Lipids, Lancet 2008; 372:224-233: Matthew J McQueen, Steven Hawken, Xingyu Wang, Stephanie Ounpuu, Allan Sniderman, Jeff rey Probstfi eld, Krisela Steyn, John E Sanderson, Mohammad Hasani, Emilia Volkova, Khawar Kazmi, and Salim Yusuf, for the INTERHEART study investigators

INTERHEART Diet, Circulation 2008; 118:: Romaina Iqbal, Sonia Anand, Stephanie Ounpuu, Shofiqul Islam, Xiaohe Zhang, Sumathy Rangarajan, Jephat Chifamba, Ali Al-Hinai, Matyas Keltai, Salim Yusuf on behalf of the INTERHEART Study Investigators

Iqbal R, Anand S, Ounpuu S, Islam S, Zhang X, Rangarajan S, Chifamba J, Al-Hinai A, Keltai M, Yusuf S; INTERHEART Study Investigators. Dietary patterns and the risk of acute myocardial infarction in 52 countries: results of the INTERHEART study.  Circulation 2008 Nov 4;118(19):1929-37

IH South Asia Lipids, JACC 2009; 53:244-53: Ganesan Karthikeyan, MD, DM, Koon K. Teo, MBBCH, PHD, FRCPC, Shofiqul Islam, MSC, Mathew J. McQueen, MD, FRCPC, Prem Pais, MD,  Xingyu Wang, PHD, Hiroshi Sato, MD, Chim Choy Lang, MD, Chitr Sitthi-Amorn, MD, M. R. Pandey, MBBS, Khawar Kazmi, MBBS, John E. Sanderson, MA, MD, FRCP, FACC, Salim Yusuf, DPHIL, FRCPC, FRSC

IH Genetics, Circulation Cardiovascular Genetics 2009; 2:16-25: Sonia S. Anand, MD, PhD, FRCPc; Changchun Xie, PhD; Guillaume Pare´, MD, MSc, FRCPc; Alexandre Montpetit, PhD; Sumathy Rangarajan, MSc; Matthew J. McQueen, MBChB, PhD, FRCPc; Heather J. Cordell, DPhil; Bernard Keavney, DM, FRCP (UK); Salim Yusuf, DPhil, FRCPc; Thomas J. Hudson, MD, PhD, FRCPc; James C. Engert, PhD; on Behalf of the INTERHEART Investigators

IH China, Heart 2009; : Koon K. Teo, MB, PhD, Lisheng Liu, MD, Clara K Chow MBBS, PhD, Xingyu Wang, PhD, Shofiqul Islam. MSc, Lixin Jiang, MD, John E Sanderson MD, Sumathy Rangarajan, MSc, Salim Yusuf, MD, DPhil, for the INTERHEART Investigators in China

Karthikeyan G, Teo KK, Islam S, McQueen MJ, Pais P, Wang X, Sato H, Lang CC, Sitthi-Amorn C, Pandey MR, Kazmi K, Sanderson JE, Yusuf S. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J Am Coll Cardiol. 2009 Jan 20;53(3):244-5

Rosengren A, Subramanian SV, Islam S, Chow CK, Avezum A Jr, Kazmi K, Sliwa K, Zubaid M, Rangarajan S, Yusuf S. Education and risk for acute myocardial infarction in 52 high, middle and low income countries. INTERHEART case-control study. Heart 2009; Oct 12.

 Mente A, Yusuf S, Islam S, McQueen MJ, Tanomsup S, Onen CL, Rangarajan S, Gerstein HC. INTERHEART Investigators. Metabolic syndrome and risk of acute myocardial infarction: a case-control study of 26,903 subjects from 52 countries. J Am Coll Cardiol 2010; 55(21): 2390-98.

Gerstein HC, Islam S, Anand S, Almahmeed W, Damasceno A, Dans A, Lang CC, Luna MA, McQueen M, Rangarajan S, Rosengren A, Wang X, Yusuf S. Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study. Diabetologia. 2010 Aug 14

McGorrian C, Yusuf S, Islam S, Jung H, Rangarajan S, Avezum A, Prabhakaran D, Almahmeed W, Rumboldt Z, Budaj A, Dans AL, Gerstein HC, Teo K, Anand SS; on behalf of the INTERHEART Investigators. Estimating modifiable coronary heart disease risk in multiple regions of the world: the INTERHEART Modifiable Risk Score. Eur Heart J 2010; Dec 22 [Epub ahead of print].

Chow CK, Islam S, Bautista L, Rumboldt Z, Yusufali A, Xie C, Anand SS, Engert JC, Rangarajan S, Yusuf S. Parental history and myocardial infarction risk across the world. J Am Coll Cardiol 2011; 57(5): 619-27

 Xu T, Li W, Teo K, Wang XY, Liu LS, Yusuf S; for the INTER-HEART China Investigators. Association of psychological risk factors and acute myocardial infarction in China: the INTER-HEART China study. Chin Med J (Engl) 2011; 124(14): 2083-88.

Do R, Xie C, Zhang X, Männistö S, Harald K, Islam S, Bailey SD, Rangarajan S, McQueen MJ, Diaz R, Lisheng L, Wang X, Silander K, Peltonen L, Yusuf S, Salomaa V, Engert JC, Anand SS; on behalf of the INTERHEART investigators. The Effect of chromosome 9p21 variants on cardiovascular disease may be modified by dietary intake: evidence from a case/control and a prospective study. PLoS Med 2011; 9(10): e1001106. Epub 2011 Oct 11.

Hu B, Li W, Wang X, Liu L, Teo K, Yusuf S. Martial status, education, and risk of acute myocardial infarction in mainland China: the INTER-HEART study. J Epidemiol 2012 Jan 14.

Held C, Iqbal R, Lear SA, Rosengren A, Islam S, Mathew J, Yusuf S. Physical activity levels, ownership of goods promoting sedentary behavior and risk of myocardial infarction: results of the INTERHEART study. Eur Heart J 2012. Jan 11 [Epub ahead of print].

  Interheart Risk Score

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