Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromso Study
Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromso Study
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DOI：
10.1177/1741826711421081
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发表时间：
2012-10-01
影响因子：
8.3
通讯作者：
Bonaa, Kaare Harald
中科院分区：
文献类型：
--
作者：
Mannsverk, Jan;Wilsgaard, Tom;Bonaa, Kaare Harald
背景：尽管过去几十年西方国家冠心病（CHD）的死亡率有所下降，但研究表明，冠心病的预防和治疗对女性的效果可能不如男性。我们在一项以挪威人口为基础的大型研究中，研究了发病率、病死率和首次心肌梗塞 (MI) 严重程度的性别和年龄特定趋势。设计：基于人口的前瞻性队列研究。方法：2004 年对 1974 年至 2001 年间总共招募的 31,323 名参与者进行了跟踪，随访期总计 400,572 人年。通过审查医院记录和死亡证明来判定疑似冠状动脉事件。共有 1669 起事件符合首次致命或非致命性 MI 的标准化标准。结果：在 35-79 岁年龄组中，男性的 MI 年龄调整发病率显着下降，而女性则有所增加。对于 80 岁以上的男性和女性，发病率保持不变。男性和女性的 MI 严重程度以及 28 天和 1 年病死率均显着下降，且相似。 结论： MI 发病率趋势因性别和年龄而异；在35-79岁年龄组中，男性的发病率明显下降，但女性的发病率有所上升，而老年患者则没有变化。两性的心肌梗死严重程度和病死率均明显降低。这些数据表明，冠心病的负担正在从中年男性转向中年女性和老年患者。
Background: Although the mortality of coronary heart disease (CHD) has declined in Western countries during the last decades, studies have suggested that the prevention and treatment of CHD may not have been as effective in women as in men. We examined gender-and age-specific trends in incidence, case fatality and the severity of first myocardial infarction (MI) in a large Norwegian population-based study.Design: Prospective population-based cohort study.Methods: A total of 31,323 participants enrolled between 1974 and 2001 were followed throughout 2004 for a total of 400,572 person-years. Suspected coronary events were adjudicated by a review of hospital records and death certificates. A total of 1669 events fulfilled standardized criteria of first-ever fatal or non-fatal MI.Results: In the age group 35-79 years, the age-adjusted incidence of MI declined significantly in men, whereas an increase was observed in women. For men and women >= 80 years the incidence rates remained unchanged. The severity of MI and the 28-day and 1-year case fatality rates declined significantly and similarly in men and women.Conclusion: Trends in MI incidence differed by sex and age; in the age group 35-79 years a marked decrease was observed among men but an increase was observed among women, while no change was observed among older patients. MI severity and case fatality were clearly reduced for both sexes. These data suggest that the burden of CHD is shifting from middle-aged men toward middle-aged women and elderly patients.