Trends in Coronary Risk Factors Among Patients with Acute Myocardial Infarction Over the Last Decade: The Yamagata AMI Registry
Trends in Coronary Risk Factors Among Patients with Acute Myocardial Infarction Over the Last Decade: The Yamagata AMI Registry
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DOI：
10.5551/jat.4671
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发表时间：
2010-01-01
影响因子：
4.4
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Nishiyama, Satoshi;Watanabe, Tetsu;Kubota, Isao
目的：最近，在日本，糖尿病和血脂异常等冠状动脉危险因素的患病率有所增加;然而，尚不清楚这是否导致急性心肌梗死（AMI）的发病率增加。我们调查了危险因素变化与日本人群AMI发病率之间的关系。方法：使用1993年至2007年山形AMI登记处的数据，研究AMI发病率（每10万人年）的趋势。我们纳入了6,222例首次AMI患者（4175例男性）。在1993-1997年、1998-2002年和2003-2007年期间，研究了三个年龄组（≥ 75岁）AMI患者的冠状动脉危险因素患病率。进一步比较近期登记的AMI患者和2,400名年龄匹配的对照者的冠状动脉危险因素。结果：男性AMI的年龄校正发病率显著增加，但女性无此差异。年轻男性AMI发病率显著增加。高血压和糖尿病的患病率在男女两性中都有所增加;然而，男性对风险因素的治疗率明显低于女性。年轻男性肥胖和高脂血症显著增加。因此，与代谢综合征相关的风险因素在年轻男性中积累。高血压、糖尿病、高胆固醇血症和吸烟是AMI的独立危险因素。结论：男性AMI发病率明显增高，尤其是年轻男性。在年轻男性中，除了传统的危险因素外，还需要对与代谢综合征相关的危险因素进行预防性护理。
Aim: Recently, there has been an increase in the prevalence of coronary risk factors, such as diabetes and dyslipidemia, in Japan; however, it is unclear whether this has resulted in an increased incidence of acute myocardial infarction (AMI). We investigated the relationship between risk factors changes and AMI incidence in a Japanese population.Methods: Trends in AMI incidence (per 100,000 person-years) were examined using data from the Yamagata AMI Registry from 1993 to 2007. We included 6,222 patients with a first-ever AMI (4175 men). The prevalence of coronary risk factors was investigated in three age groups of AMI patients (= 75 years) for the periods 1993-1997, 1998-2002, and 2003-2007. Coronary risk factors were further compared between recently registered AMI patients and 2,400 age-matched controls.Results: The age-adjusted incidence of AMI increased significantly in men, but not in women. Younger men particularly showed a significant increase in the incidence of AMI. The prevalence of hypertension and diabetes increased in both genders; however, the prevalence of treatment for risk factors was significantly lower in men than women. Younger men showed significant increases in obesity and hypertriglyceridemia. Consequently, risk factors associated with the metabolic syndrome had accumulated among younger men. We revealed that hypertension, diabetes, hypercholesterolemia and current smoking were independent risk factors for AMI.Conclusions: The incidence rate for AMI increased significantly in men, especially younger men. Preventive care for risk factors associated with metabolic syndrome, in addition to conventional risk factors, may be required in younger men.