Living alone and risk of cardiovascular events following discharge after acute myocardial infarction in Japan
Living alone and risk of cardiovascular events following discharge after acute myocardial infarction in Japan
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DOI：
10.1016/j.jjcc.2013.04.009
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发表时间：
2013-09-01
影响因子：
2.5
通讯作者：
Komuro, Issei
中科院分区：
文献类型：
--
作者：
Kitamura, Tetsuhisa;Sakata, Yasuhiko;Komuro, Issei
背景：在日本单独生活的急性心肌梗死（AMI）幸存者出院后心血管事件的长期风险知之甚少。方法和结果：2002年1月至2010年12月，在大阪地区进行了一项大规模前瞻性观察性研究，纳入了连续的AMI患者。我们评估了单独生活与AMI出院后心血管事件纵向风险之间的关系。使用Cox比例风险模型来评估独居与主要心血管不良事件和总死亡人数组成的主要复合终点之间的关系。研究期间共登记5845例患者，其中男性4415例，女性1430例。发现独居与由主要不良心血管事件和总死亡组成的复合终点的较高风险独立相关[校正危险比（HR） 1.32；95%置信区间（Cl）： 1.11-1.58)。多因素调整后的复合终点hr男性患者为1.34(95% CI: 1.08-1.68)，女性患者为1.31（95% CI: 0.95-1.81）。不论年龄和性别，独居AMI幸存者的综合终点调整HR均高于非独居AMI幸存者。结论：从大阪的这个大型AMI登记中，出院后独居的AMI幸存者心血管事件和总死亡风险高于非独居者。(C) 2013年日本心脏病学会。Elsevier Ltd.出版。版权所有。
Background: Little is known about the long-term risk of cardiovascular events after discharge among acute myocardial infarction (AMI) survivors living alone in Japan.Methods and results: A large-scale prospective, observational study in the Osaka region involved consecutive patients with AMI from January 2002 through December 2010. We evaluated the association between living alone and longitudinal risk of cardiovascular events following discharge after AMI. A Cox proportional-hazards model was used to assess the association between living alone and the primary composite endpoint consisting of major adverse cardiovascular events and total deaths. During the study period, 5845 patients (4415 male patients, 1430 female patients) were registered. Living alone was found to be independently associated with a higher risk of composite endpoint consisting of major adverse cardiovascular events and total deaths [adjusted hazard ratio (HR) 1.32; 95% confidence interval (Cl): 1.11-1.58). Multivariate-adjusted HRs of composite endpoint were 1.34(95% CI: 1.08-1.68) among male patients and 1.31(95% CI: 0.95-1.81) in the female patients. AMI survivors living alone tend to have a higher adjusted HR of composite endpoint than those not living alone irrespective of age and gender groups.Conclusions: From this large AMI registry in Osaka, AMI survivors living alone after discharge had a higher risk of cardiovascular events and total deaths than those not living alone. (C) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.