RT Journal Article SR Electronic T1 Cardiovascular risk factors and autonomic indices in relation to fatal and non-fatal coronary events JF Open Heart JO Open Heart FD British Cardiovascular Society SP e001445 DO 10.1136/openhrt-2020-001445 VO 8 IS 1 A1 Christian Zambach A1 Artur Fedorowski A1 Yan Borné A1 Linda S B Johnson A1 Sofia Gerward A1 Viktor Hamrefors A1 Gunnar Engström YR 2021 UL http://openheart.bmj.com/content/8/1/e001445.abstract AB Objective Mortality caused by coronary artery disease has markedly decreased in recent years. However, a substantial proportion of patients suffering a coronary event (CE) die within the first day, most of them out of hospital. We aimed to investigate how established cardiovascular (CV) risk factors and CV autonomic indices associate with fatal versus non-fatal CEs in the population.Methods 33 057 individuals (mean age; 45.6 years; 10 773 women) free of coronary artery disease at baseline were included. Baseline examination, including assessment of traditional CV risk factors and autonomic indices such as heart rate and orthostatic reaction, was performed during 1974–1992, after which the subjects were monitored for incident CV disease. The Lunn-McNeil competing risks approach with a prespecified multivariable model was used to assess differences in risks for fatal and non-fatal CEs in relation to baseline CV risk factors.Results During follow-up period of 29.7 years, 5494 subjects (6.10/1000 person-years) had first CE; 1554 of these were fatal. Age, male gender, smoking, body mass index (BMI), blood pressure, pulse pressure and resting heart rate had stronger relationships with fatal CE than with non-fatal events. The effects of diabetes, serum cholesterol, antihypertensive treatment and orthostatic blood pressure responses were similar for fatal and non-fatal CE.Conclusions Several cardiovascular risk factors, such as smoking, high BMI, blood pressure and high resting heart rate, were preferentially associated with fatal compared with non-fatal CEs. These observations may require special attention in the overall efforts to further reduce coronary artery disease mortality.Data are available on reasonable request. Please contact the corresponding author.