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Sexual Activity Triggering Myocardial Infarction: Title and subTitle BreakOne Less Thing to Worry About FREE

Robert F. DeBusk, MD
[+] Author Affiliations

Reprints: Robert F. DeBusk, MD, Director, Stanford Cardiac Rehabilitation Program, 780 Welch Rd, Suite 106, Palo Alto, CA 94304-1517.


JAMA. 1996;275(18):1447-1448. doi:10.1001/jama.1996.03530420075041
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Contemporary therapy for acute myocardial infarction (MI), including thrombolytic and other adjunctive drug therapies1 and direct percutaneous transluminal coronary angioplasty,2 has dramatically lowered the short-term mortality from this condition. Moreover, lipid-lowering drug therapy, aspirin, and β-blockers,3 as well as angiotensin-converting enzyme inhibitors for left ventricular dysfunction,4 given in the postacute phase, have decreased not only the rate of reinfarction and death but also the rate of rehospitalization for unstable angina pectoris and the need for coronary revascularization.5 In short, the prospects for a rapid and complete recovery from acute MI and avoidance of future cardiac events have never been better. However, despite these favorable prospects, physicians and patients are too often burdened by the misconception that sexual activity after acute MI is dangerous.

See also p 1405.

The report of Muller et al6 in this issue of The Journal indicates that the actual risk

REFERENCES

The GUSTO Investigators.  An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med . 1993;;329: 673-682.
Weaver WD, Litwin PE, Martin JS.  Use of direct angioplasty for treatment of patients with acute myocardial infarction in hospitals with and without on-site cardiac surgery. Circulation . 1993;;88:2067-2075.
Consensus Panel Statement.  Preventing heart attack and death in patients with coronary disease. Circulation . 1995;;92:2-4.
The SOLVD Investigators.  Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med . 1991;; 325:293-302.
Scandinavian Simvastatin Survival Study Group.  Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet . 1994;;344:1383-1389.
Muller JE, Mittleman MA, Maclure M, Sherwood JB, Toiler GH, for the Determinants of Myocardial Infarction Onset Study Investigators.  Triggering myocardial infarction by sexual activity: low absolute risk and prevention by regular physical exertion. JAMA . 1996;;275:1405-1409.
Maclure M.  The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol . 1991;;133:144-153.
Muller JE, Abela GS, Nesto RW, Toiler GH.  Triggers, acute risk factors and vulnerable plaques: the lexicon of a new frontier. J Am Coll Cardiol . 1994;;23:809-813.
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE, for the Determinants of Myocardial Onset Study Investigators.  Triggering of acute myocardial infarction by heavy physical exertion: protection against triggering by regular exertion. N Engl J Med . 1993;;329:1677-1683.
Green LH, Seroppian E, Handlin RI.  Platelet activation during exercise-induced myocardial ischemia. N Engl J Med . 1980;;302:193-197.
Speiser W, Langer W, Pschaick A.  Increased blood fibrinolytic activity with different sporting activities and in patients after myocardial infarction taking part in a rehabilitation sports program. Thromb Res . 1988;;51:543-555.
Clausen JP.  Effect of physical training on cardiovascular adjustments to exercise in man. Physiol Rev . 1977;;57:779-815.
Stein RA.  The effect of exercise training on heart rate during coitus in the post myocardial infarction patient. Circulation . 1977;;55:738-740.
Falk E.  Why do plaques rupture? Circulation . 1992;;86( (suppl 6) ):11130-11142.

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The GUSTO Investigators.  An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med . 1993;;329: 673-682.
Weaver WD, Litwin PE, Martin JS.  Use of direct angioplasty for treatment of patients with acute myocardial infarction in hospitals with and without on-site cardiac surgery. Circulation . 1993;;88:2067-2075.
Consensus Panel Statement.  Preventing heart attack and death in patients with coronary disease. Circulation . 1995;;92:2-4.
The SOLVD Investigators.  Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med . 1991;; 325:293-302.
Scandinavian Simvastatin Survival Study Group.  Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet . 1994;;344:1383-1389.
Muller JE, Mittleman MA, Maclure M, Sherwood JB, Toiler GH, for the Determinants of Myocardial Infarction Onset Study Investigators.  Triggering myocardial infarction by sexual activity: low absolute risk and prevention by regular physical exertion. JAMA . 1996;;275:1405-1409.
Maclure M.  The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol . 1991;;133:144-153.
Muller JE, Abela GS, Nesto RW, Toiler GH.  Triggers, acute risk factors and vulnerable plaques: the lexicon of a new frontier. J Am Coll Cardiol . 1994;;23:809-813.
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE, for the Determinants of Myocardial Onset Study Investigators.  Triggering of acute myocardial infarction by heavy physical exertion: protection against triggering by regular exertion. N Engl J Med . 1993;;329:1677-1683.
Green LH, Seroppian E, Handlin RI.  Platelet activation during exercise-induced myocardial ischemia. N Engl J Med . 1980;;302:193-197.
Speiser W, Langer W, Pschaick A.  Increased blood fibrinolytic activity with different sporting activities and in patients after myocardial infarction taking part in a rehabilitation sports program. Thromb Res . 1988;;51:543-555.
Clausen JP.  Effect of physical training on cardiovascular adjustments to exercise in man. Physiol Rev . 1977;;57:779-815.
Stein RA.  The effect of exercise training on heart rate during coitus in the post myocardial infarction patient. Circulation . 1977;;55:738-740.
Falk E.  Why do plaques rupture? Circulation . 1992;;86( (suppl 6) ):11130-11142.
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