复发性心肌梗塞的长期结果:一项全国性的丹麦研究
Daniel Mølager Christensen1,2, Deewa Zahir1, Caroline Hartwell Garred1
1Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark.
European heart journal. Acute cardiovascular care
|August 1, 2025
概括
复发性心肌梗塞 (MI) 后的结果有所改善,死亡率和随后的MI降低. 然而,心力衰竭住院仍然是一个问题,需要针对复发性心脏病发作患者制定有针对性的预防策略.
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:
- 在过去的几十年中,第一次心肌梗塞 (MI) 的结果显著改善.
- 复发性心脏病发作后的预后尚未对类似改善进行充分研究.
研究的目的:
- 为了评估复发性心肌梗塞 (MI) 后的预后趋势.
- 评估发生的死亡率变化,心力衰竭住院情况,以及在患有复发性心脏病发作的患者中发生的后续心脏病发作.
主要方法:
- 丹麦一项基于国家登记的全国性研究 (2003-2022) 包括所有首次复发性心脏病发作的患者.
- 计算了累积发病率和标准化风险比率 (sRR) 的死亡率,心力衰竭 (HHF) 的住院治疗,以及随后的复发性心脏病发作.
- 按年龄,性别和基线心力衰竭 (HF) 状态进行了分层分析.
主要成果:
- 总共有24,799名患有复发性心脏病发作的患者被确定,随着时间的推移,中位数年龄下降和并发症增加.
- 观察到强化药理 (增加降脂治疗) 和侵入性管理 (增加冠状动脉血管图和PCI).
- 五年死亡率从54.1%降至37.3% (sRR:0.78),五年HHF发病率从13.6%降至11.7% (sRR:0.76),五年后的复发性心脏病发病率从23.4%降至17.7% (sRR:0.65).
- 虽然死亡率和随后的MI在各个子组下降,但5年HHF发病率在先前患有HF的患者和75岁以上的男性中增加.
结论:
- 再发性心脏病发作后的死亡率有所下降,与强化药物治疗和侵入性治疗并行.
- 由于心力衰竭 (HHF) 住院的情况略有改善,这表明需要有针对性的预防策略.
- 有针对性的预防措施对于减轻复发性心肌梗塞 (MI) 患者心力衰竭风险至关重要.
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