间歇性ST抑郁和心肌梗塞后的死亡率
W Ruberman1, R Crow, C R Rosenberg
1Department of Environmental Medicine, New York University School of Medicine, NY 10010-2598.
Circulation
|April 1, 1992
概括
间歇性ST抑郁症 (STD) 在未经治疗的心肌梗塞后患者中显著增加死亡风险. 普罗巴诺洛尔可以降低这种风险,这表明它具有抗缺血性保护作用.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 发病率和死亡率研究 疾病和死亡率研究
背景情况:
- 评估间歇性ST抑郁症 (STD) 对心肌梗塞 (MI) 后患者死亡率的影响.
- 利用Beta阻断器心脏病发作试验的数据进行病例对照分析.
研究的目的:
- 为了确定间歇性ST抑郁症对死亡率的贡献.
- 调查普拉诺洛尔对性病相关死亡率的潜在保护作用.
主要方法:
- 对24小时心电图带进行计算机分析,以检测ST抑郁 (>= 0.1mV>= 1分钟).
- 由训练有素的读者对计算机检测到的ST事件进行验证.
- 病例控制分析比较261例死亡与匹配的对照,调整为共变量.
主要成果:
- 间歇性ST抑郁症 (STD) 与1.73的死亡率相对风险 (RR) 有关.
- 在未接受治疗的患者中,性传播疾病的RR比较高,为2.56,而在接受了普拉诺洛尔治疗的患者中,RR为0.98.
- 在安慰剂组中观察到剂量依赖关系,性传播疾病>30分钟显示RR为4.33.
结论:
- 在24小时监测中,过渡性ST抑郁症对未经治疗的早期后心脏病幸存者的死亡率有显著的贡献.
- 普罗普拉诺洛尔的减少效果表明它具有抗胰岛症机制,可能会防止死亡.
- 需要进行进一步的试验,以探索减少性传播疾病是否能改善生存结果.
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