在Q波心肌梗塞后发生事件率的时间趋势:弗雷明汉心脏研究
U C Guidry1, J C Evans, M G Larson
1National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA.
Circulation
|November 16, 1999
概括
由于治疗方法的改进,Q波心肌梗塞 (MI) 后的长期死亡率显著下降. 然而,复发性心肌梗塞和充血性心力衰竭 (CHF) 的风险仍然没有变化,可能是由于高风险患者的存活率增加.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 在Q波心肌梗塞 (MI) 后的短期死亡率有所下降.
- 在Q波MI后的长期结果需要进一步调查.
- 四十年来心脏病发作后的后续状况的趋势并未得到很好的确立.
研究的目的:
- 调查Q波心肌梗塞 (MI) 后长期后果风险的时间趋势.
- 分析四十年来冠心病 (CHD) 死亡,全因死亡率,再发作和充血性心力衰竭 (CHF) 风险的变化.
- 评估不断发展的后心脏病治疗对长期结果的影响.
主要方法:
- 从1950年至1989年,对546名Framingham心脏研究对象进行了分析,这些对象患有Q波MI.
- 对心脏病死亡,全因死亡,复发心脏病和心脏病发作风险的比较,跨越三个时间段:1950年至1969年,1970年至1979年和1980年至1989年.
- 计算危险比率 (HRs) 以评估结果风险的时间趋势.
主要成果:
- 与1950-1969年相比,在20世纪70年代 (HR,0.69) 和80年代 (HR,0.48) 观察到冠心病 (CHD) 死亡风险显著降低.
- 在过去的几十年中,所有原因的死亡率也大幅下降 (1970年代HR,0.70;1980年代HR,0.59).
- 在复发性心肌梗塞 (MI) 或充血性心力衰竭 (CHF) 的风险中没有发现显著的时间变化.
结论:
- 改进的后心脏病治疗导致心脏病死亡率和全因死亡率大幅降低.
- 缺少慢性心血管疾病发病率的下降可能归因于左心室功能受损的患者的存活率增加.
- 长期管理策略需要解决Q波MI后慢性心血管衰竭的持续风险.
相关概念视频
01:29Electrocardiogram
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...