Assessing the global burden of ischemic heart disease, part 2: analytic methods and estimates of the global epidemiology of ischemic heart disease in 2010.
Assessing the global burden of ischemic heart disease, part 2: analytic methods and estimates of the global epidemiology of ischemic heart disease in 2010.
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DOI：
10.1016/j.gheart.2012.10.003
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发表时间：
2012-12-01
期刊：
影响因子：
3.7
通讯作者：
Murray, Christopher J L
中科院分区：
文献类型：
--
作者：
Forouzanfar, Mohammad H;Moran, Andrew E;Flaxman, Abraham D;Roth, Gregory;Mensah, George A;Ezzati, Majid;Naghavi, Mohsen;Murray, Christopher J L
缺血性心脏病（IHD）是全球主要的死亡原因。2010年全球疾病、伤害和风险因素负担（GBD）研究估计了1990年至2010年世界21个地区的IHD死亡率和残疾负担。GBD IHD流行病学估计的数据来源是死亡率监测、死因推断和生命登记数据（IHD死亡率）以及1980-2008年发表的IHD流行病学文献的系统综述（非致死性IHD结局）。一个估计和验证过程导致了一个整体模型的IHD死亡率的国家为所有21个世界地区，调整国家一级的协变量。为IHD的非致命性后遗症开发了疾病模型：心肌梗死、稳定型心绞痛和缺血性心力衰竭。国家水平的协变量，包括代谢和营养风险因素，教育，战争，人均年收入有助于集成模型分析IHD死亡。在急性心肌梗死模型中，将肌钙蛋白纳入2000年后发表的研究的诊断标准与50%的高发病率相关。与Rose心绞痛问卷调查的“明确”心绞痛相比，自我报告的心绞痛诊断显著高估了稳定型心绞痛的患病率。2010年，东欧和中亚的IHD死亡率最高，亚太高收入地区、东亚、拉丁美洲安第斯山脉和撒哈拉以南非洲地区的死亡率最低。需要全球和区域IHD流行病学估计来估计IHD的全球负担。使用描述性荟萃分析工具，GBD 2010通过调整区域水平的死亡率和风险因素数据以及研究水平的诊断方法来标准化和汇总国际数据。分析最大限度地提高了内部一致性，普遍性，并调整已知的偏见来源。然而，GBD IHD分析强调了许多地区需要改进IHD流行病学监测以及统一诊断标准的必要性。
Ischemic Heart Disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Injuries and Risk Factors (GBD) 2010 Study estimated IHD mortality and disability burden for 21 world regions for the years 1990 to 2010. Data sources for GBD IHD epidemiology estimates were mortality surveillance, verbal autopsy, and vital registration data (for IHD mortality) and systematic review of IHD epidemiology literature published 1980–2008 (for non-fatal IHD outcomes). An estimation and validation process led to an ensemble model of IHD mortality by country for all 21 world regions, adjusted for country-level covariates. Disease models were developed for the nonfatal sequelae of IHD: myocardial infarction, stable angina pectoris, and ischemic heart failure. Country level covariates including metabolic and nutritional risk factors, education, war, and annual income per capita contributed to the ensemble model for the analysis of IHD death. In the acute myocardial infarction model, inclusion of troponin in the diagnostic criteria of studies published after the year 2000 was associated with a 50% higher incidence. Self-reported diagnosis of angina significantly overestimated stable angina prevalence compared with “definite” angina elicited by the Rose angina questionnaire. For 2010, Eastern Europe and Central Asia had the highest rates of IHD death and the Asia Pacific High-Income, East Asia, Latin American Andean, and sub-Saharan Africa regions had the lowest. Global and regional IHD epidemiology estimates are needed for estimating the worldwide burden of IHD. Using descriptive meta-analysis tools, the GBD 2010 standardized and pooled international data by adjusting for region-level mortality and risk factor data, and study level diagnostic method. Analyses maximized internal consistency, generalizability, and adjustment for known sources of bias. The GBD IHD analysis nonetheless highlights the need for improved IHD epidemiology surveillance in many regions and the need for uniform diagnostic standards.