1999年から2020年までの米国におけるCKDによる急性心筋梗塞による死亡傾向:CDC WONDERデータベースの横断分析
Rayyan Nabi1, Muhammad Hussain Mansoor2, Muhammad Hassan Shahbaz2
1Islamic International Medical College, Riphah International University, Islamabad, Pakistan.
International urology and nephrology
|August 26, 2025
まとめ
慢性腎臓病患者の急性心筋梗塞 (心臓発作) による死亡率は減少しました. しかし,異なる性別,人種,地理的な場所の間で重要な格差が残っています.
科学分野:
- 心血管医学
- 腎臓科
- 公衆衛生
背景:
- 慢性腎臓病 (CKD) は急性心筋梗塞 (AMI) の重要な危険因子であり,患者のアウトカムを悪化させる.
- 心血管疾患の治療の進歩にも関わらず 死亡率の格差は様々な集団で 続いている.
研究 の 目的:
- 米国におけるCKD患者におけるAMI関連死亡率の動向を調査する.
- 1999年から2020年までの性,人種/民族,地理的要因に基づくAMI関連死亡率の格差を特定し,分析する.
主な方法:
- CDC WONDERデータベース (1999-2020) から得られた全国死亡率のデータ分析.
- 主な原因としてAMI (ICD-10コード I21-I22) と貢献要因としてCKD (ICD-10 N18) の死亡の特定.
- 年齢調整による死亡率の計算とJoinpoint回帰を用いた傾向の評価
主要な成果:
- CKD患者 (25歳から85歳) のうち,AMIに関連した死亡者は合計72, 780人であった.
- 年齢調整した全体的な死亡率は1999年の2.46から2020年の0.99に減少した (APC: -4.09%).
- 死亡率は男性,非ヒスパニック系黒人,および都市部以外の地域で高かった. 2015年から2020年にかけて,ヒスパニック系患者の死亡率が著しく増加した.
結論:
- 慢性腎臓病患者の全般的なAMI関連死亡率は減少しているが,大きな差異は残っている.
- 性別,人種/民族,地理的な位置に基づく結果の持続的な不平等に対処するには,標的の介入が不可欠です.
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