心肌梗塞后的过度死亡率和预期寿命:基于登记的匹配队列研究
Christian Reitan1, Pontus Andell2, Joakim Alfredsson3
1Department of Clinical Sciences, Danderyd Hospital (C.R., T.J.), Karolinska Institutet, Stockholm, Sweden.
Circulation
|July 5, 2024
概括
心肌梗塞 (MI) 显著减少了预期寿命,特别是在年轻人,女性和左心室喷射率 (LVEF) 降低的人群中. 然而,心脏病发作治疗近30年来将预期寿命减少了一半.
科学领域:
- 心脏病学
- 公共卫生
- 流行病学
背景情况:
- 由于心肌梗塞的流行,研究心肌梗塞对预期寿命的影响具有挑战性.
- 这项研究将心脏病患者的预期寿命与没有心脏病史的对照人群进行比较.
研究的目的:
- 评估心脏病对预期寿命的影响.
- 根据年龄,性别和左心室喷射率 (LVEF) 分析这些影响.
主要方法:
- 使用SWEDEHEART注册表,将335,748名心脏病患者与1,625,396名对照患者进行匹配.
- 使用灵活的参数生存模型来估计过度死亡率和预期寿命 (LOLE).
- 根据年龄,性别,地区,指数年和LVEF进行调整.
主要成果:
- 在年轻人,女性和LVEF降低的人群中观察到较高的LOLE (< 50%).
- 在2022年,50岁女性的LOLE从9.5年减少LVEF到80岁男性的LVEF保持3.7个月.
- 在1992年至2022年间,调整后的平均LOLE在不同年龄和性别群体下降了36%~55%.
结论:
- 年轻患者,女性和LVEF降低患者的LOLE较高,但伴随性疾病减轻了这一现象.
- 30年来心脏病治疗的进步几乎使LOLE减少了一半,
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