過剰な死亡率と心筋梗塞後の生存期間の減少:登録ベースのマッチングコホート研究
Christian Reitan1, Pontus Andell2, Joakim Alfredsson3
1Department of Clinical Sciences, Danderyd Hospital (C.R., T.J.), Karolinska Institutet, Stockholm, Sweden.
Circulation
|July 5, 2024
まとめ
心筋梗塞 (MI) は,特に若者,女性,および左心室排出分数 (LVEF) が減少した人の平均寿命を大幅に短縮します. しかし,心筋梗塞の治療は 30年以上の寿命の減少を ほぼ半減させました.
科学分野:
- 心臓病科
- 公衆衛生
- 流行病学
背景:
- 心筋梗塞 (MI) の平均寿命への影響の研究は,その流行により困難です.
- この研究では,心筋梗塞の患者と,心筋梗塞の歴のない対照群の平均寿命を比較した.
研究 の 目的:
- 心臓発作が寿命に与える影響を評価する.
- 年齢,性別,左心室排出分数 (LVEF) に基づいてこれらの効果を分析する.
主な方法:
- SWEDEHEARTのレジストリを利用し,1,625,396人の対照群と335,748人の心臓発作患者が一致しました.
- 柔軟なパラメトリック生存モデルを使用して,過剰な死亡率と寿命の減少 (LOLE) を推定しました.
- 年齢,性別,地域,インデックス年,およびLVEFに調整されています.
主要な成果:
- 若い人,女性,およびLVEFが低下した人 (< 50%) で,より高いLOLEが観察されました.
- 2022年には,LVEFが減少した50歳の女性のLOLEは9.5歳から,LVEFが維持された80歳の男性のLOLEは3.7ヶ月であった.
- 1992年から2022年の間に,調整された平均LOLEは年齢と性別で36%~55%減少した.
結論:
- LOLEは若い患者,女性,およびLVEFが低下した患者で高くなっていますが,これは併発症によって軽減されます.
- 30年にわたる心臓発作治療の進歩により,LOLEはほぼ半減し,継続的な低下傾向を示しています.
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