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住院心肌梗塞发生率,严重程度和结局的趋势
Véronique L Roger1, Susan A Weston, Yariv Gerber
1MPH, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. roger.veronique@mayo.edu
Circulation
|February 10, 2010
概括
引入托波素测定显著改变了心肌梗塞 (MI) 诊断,增加了非ST段升高MI病例. 虽然30天生存率有所改善,但长期结果和死亡原因发生了变化.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 生物标志物 生物标志物
背景情况:
- 心肌梗塞 (MI) 的诊断标准在2000年发生了转变,优先考虑的是托波,而不是肌酸酶 (CK) 和CK-MB.
- 这种诊断变化对心脏病发病率和患者结局的影响仍然不清楚.
研究的目的:
- 调查以热素为基础的定义对心脏病发病率,严重程度和生存趋势的影响.
- 分析MI流行病学的变化以及在采用热素测定之前和之后的结果.
主要方法:
- 一项以社区为基础的研究分析了在1987年至2006年期间因发生性心脏病入院的2816名患者.
- 从2000年8月起收集了前性热素和CK-MB测量结果.
- 在不同诊断时期对心脏病发病率,严重程度和生存率进行了比较.
主要成果:
- 仅包括热波的病例并没有改变整体肌痛性心脏病发病率 (1987年至2006年);然而,排除它们显示了20%的下降.
- 热诺使用显著增加非ST段升高MI诊断,而ST段升高MI诊断下降.
- 心脏病发作后的30天死亡率显著改善 (2006年HR为0.44而不是1987年),死亡原因从心血管转变为非心血管.
结论:
- 转向托罗邦尼诊断的转变部分解释了不断发展的MI流行病学,非ST段升高MI变得占主导地位.
- 尽管短期生存率有所改善,但长期生存趋势保持不变.
- 在MI后,从心血管到非心血管的死亡原因发生了显著的转变.
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