Reduction in sudden deaths and coronary mortality in myocardial infarction patients after rehabilitation. 15 year follow-up study.
Reduction in sudden deaths and coronary mortality in myocardial infarction patients after rehabilitation. 15 year follow-up study.
复制标题
心肌梗塞患者康复后猝死和冠心病死亡率降低。
DOI：
10.1093/oxfordjournals.eurheartj.a060837
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发表时间：
1995
影响因子：
39.3
通讯作者：
L. Knuts
中科院分区：
文献类型：
--
作者：
Helena Hämäläinen;O. Luurila;V. Kallio;L. Knuts
本研究旨在评估急性心肌梗死后持续3年的综合康复和二级预防计划对死亡率的长期影响。研究组包括375名65岁以下的连续非选择患者，随机分配到干预组（188名患者）或对照组（187名患者）。随访15年后，与对照组相比，干预组的猝死发生率（16.5% vs 28.9%，P = 0.006）和冠状动脉死亡率（47.9% vs 58.5%，P = 0.04）显著降低。总死亡率分别为64.4%和66.8%（ns）。干预组的癌症死亡率为16人，对照组为3人。心力衰竭、心脏扩大、纽约心脏协会心功能分级II级或以上以及对照组成员与前3年的冠状动脉死亡率显著相关，3年后心脏扩大、糖尿病和再梗死与晚期冠状动脉死亡相关。因此，急性心肌梗死后的综合多因素干预对冠心病死亡率和猝死有良好的长期影响，但对总死亡率无影响。
The study was set up to evaluate the long-term effects on mortality of a comprehensive rehabilitation and secondary prevention programme lasting 3 years after acute myocardial infarction. The study group consisted of 375 consecutive, non-selected patients under 65 years of age randomly allocated to an intervention group (188 patients) or a control group (187 patients). After 15 years follow-up significantly lower incidence of sudden death (16.5% vs 28.9%, P = 0.006) and coronary mortality (47.9% vs 58.5%, P = 0.04) were seen in the intervention group compared with controls. Total mortality was 64.4% and 66.8%, respectively (ns). The incidence of cancer death was 16 in the intervention group and three in the controls. Cardiac failure, enlarged heart, New York Heart Association functional class II or more and membership in the control group were significantly associated with coronary mortality during the first 3 years, and after 3 years enlarged heart, diabetes and reinfarction were associated with late coronary death. Thus, comprehensive multifactorial intervention after acute myocardial infarction had favourable long-term effects on coronary mortality and sudden death but no effect on total mortality.