1987年至2002年心肌梗塞的严重程度下降:社区动脉样硬化风险研究 (ARIC)
Merle Myerson1, Sean Coady, Herman Taylor
1EdD, Director, Cardiovascular Disease Prevention Program, Division of Cardiology, St Luke's-Roosevelt Hospital of Columbia University, 1111 Amsterdam Ave, New York, NY 10025, USA. myersonM@optonline.net
Circulation
|January 21, 2009
概括
从1987年到2002年,急性心肌梗塞 (MI) 的严重程度显著下降. 这种心脏病发作严重程度的降低可能解释了冠心病死亡率的下降.
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:
- 美国冠心病 (CHD) 死亡率有所下降,但根本原因尚不清楚.
- 这种下降的潜在原因之一是急性心肌梗塞 (MI) 严重程度的降低.
- 社区动脉样硬化风险研究 (ARIC) 调查了心脏病发作严重程度随时间的变化.
研究的目的:
- 为了测试急性心肌梗塞 (MI) 的严重程度下降的假设.
- 分析1987年至2002年住院患者中心脏病发作严重程度的趋势.
主要方法:
- 该ARIC研究的社区监测组件追踪了35-74岁的住户,他们患有住院内心脏病或致命的冠心病.
- 使用胸痛,心电图和心脏生物标志物识别和分类住院的MI病例.
- 从医院图表中提取MI严重性指标,包括心电图异常,心脏酶水平,以及冲击和心力衰竭等临床结果.
主要成果:
- 在1987年至2002年期间,MI严重性指标的显著下降被观察到.
- 与ST段升高,Q波和主要Q波相关的MI病例的比例每年都在下降.
- 肌酸激酶,肌酸激酶-MB的水平,以及休克的发生率也下降了.
- 在心脏病工具 (PREDICT) 中预测死亡风险得分显示显著下降.
- 趋势在不同的人口群体中是一致的,包括黑人个人和女性.
结论:
- 来自ARIC研究的社区监测数据表明,住院患者中急性心脏病发作的严重程度有所降低.
- 这种心脏病发作严重程度的降低是导致心脏病死亡率下降的潜在因素.
- 进一步的研究可能会探索心脏病发作严重程度降低与其他影响心脏病死亡率的因素的相互作用.
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