第一次心肌梗塞:风险因素,症状和医疗治疗
Nick S Nurmohamed1,2,3, Quyen Ngo-Metzger4, Pam R Taub5
1Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
European heart journal
|July 3, 2025
概括
许多首次心脏病发作发生在没有先前症状或已识别的危险因素的情况下. 许多患有风险因素和症状的患者没有接受预防性治疗,这表明需要更好的风险识别工具.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 全球动脉样硬化心血管疾病负担正在上升,尽管风险算法.
- 关于心肌梗塞前症状和风险因素的现实数据有限.
- 现有的风险分层可能无法充分识别所有患心脏病发作风险的患者.
研究的目的:
- 在第一次心脏病发作之前,确定已记录的冠状动脉疾病风险因素的流行率.
- 评估第一个心脏病发作之前记录的症状和医生访问的频率.
- 评估患者在第一次心脏病发作之前接受预防性医疗治疗的情况.
主要方法:
- 使用美国大型真实世界数据集 (Clarivate真实世界数据产品) 的回顾性队列研究.
- 包括18岁以上的患者,在2017年1月至2022年9月期间发生了第一次心脏病发作.
- 评估记录心脏症状的流行率,标准可修改风险因素 (SMuRFs),医生访问和预防性治疗使用先前的MI.
主要成果:
- 发现了超过460万首次心脏病发作患者 (平均年龄70岁,42.3%为女性).
- 在心脏病发作之前,50.5%的人缺乏记录的症状,18.0%的人缺乏SMuRF,63.4%的人没有接受预防性治疗.
- 年轻的患者 (≤60) 和男性有较少的记录症状/SMuRFs和较少的预防性治疗使用.
结论:
- 一半的初发性心脏病患者缺乏先前症状,约20%没有发现SMuRFs.
- 大多数患有MI前症状和SMuRFs的患者在预防性治疗中治疗不足.
- 迫切需要改进的MI风险识别工具,以促进预防性治疗.
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