Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction.
Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction.
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DOI：
10.1001/jama.2011.1654
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发表时间：
2011-11-16
影响因子：
120.7
通讯作者：
Greenland, Philip
中科院分区：
文献类型：
--
作者：
Canto, John G.;Kiefe, Catarina I.;Rogers, William J.;Peterson, Eric D.;Frederick, Paul D.;French, William J.;Gibson, C. Michael;Pollack, Charles V., Jr.;Ornato, Joseph P.;Zalenski, Robert J.;Penney, Jan;Tiefenbrunn, Alan J.;Greenland, Philip
在社区实践中，很少有研究探讨冠心病危险因素的数量与急性心肌梗死结局之间的关系。确定首次心肌梗死患者中冠心病危险因素的数量与住院死亡率之间的关系。国家心肌梗死登记处的观察性研究，1994-2006年。我们研究了542008例首次心肌梗死且既往无心血管疾病的患者是否存在5种主要的传统冠心病危险因素（高血压、吸烟、血脂异常、糖尿病和冠心病家族史）和住院死亡率。全因住院死亡率。大多数（85.6%）首次出现心肌梗死的患者至少有5种冠心病危险因素中的1种，14.4%的患者没有5种危险因素。年龄与冠心病危险因素的数量成反比，从平均年龄71.5岁（0个危险因素）到56.7岁（5个危险因素）（趋势P <0.001）。因各种原因而在医院内死亡的总人数是50 788。对于具有0、1、2、3、4和5个风险因素的患者，未校正的住院死亡率分别为14.9%、10.9%、7.9%、5.3%、4.2%和3.6%。在调整年龄和其他临床因素后，冠心病危险因素的数量与住院死亡率调整的比值比（1.54; 95%CI，1.23-1.94）之间呈负相关，其中0 vs 5个危险因素。这种关联在几个年龄层和重要患者亚组中是一致的。在既往无心血管疾病的急性心肌梗死患者中，住院死亡率与冠心病危险因素数量呈负相关。
Few studies have examined the association between the number of coronary heart disease risk factors and outcomes of acute myocardial infarction in community practice. To determine the association between the number of coronary heart disease risk factors in patients with first myocardial infarction and hospital mortality. Observational study from the National Registry of Myocardial Infarction, 1994-2006. We examined the presence and absence of 5 major traditional coronary heart disease risk factors (hypertension, smoking, dyslipidemia, diabetes, and family history of coronary heart disease) and hospital mortality among 542 008 patients with first myocardial infarction and without prior cardiovascular disease. All-cause in-hospital mortality. A majority (85.6%) of patients who presented with initial myocardial infarction had at least 1 of the 5 coronary heart disease risk factors, and 14.4% had none of the 5 risk factors. Age varied inversely with the number of coronary heart disease risk factors, from a mean age of 71.5 years with 0 risk factors to 56.7 years with 5 risk factors (P for trend <.001). The total number of in-hospital deaths for all causes was 50 788. Unadjusted in-hospital mortality rates were 14.9%, 10.9%, 7.9%, 5.3%, 4.2%, and 3.6% for patients with 0, 1, 2, 3, 4, and 5 risk factors, respectively. After adjusting for age and other clinical factors, there was an inverse association between the number of coronary heart disease risk factors and hospital mortality adjusted odds ratio (1.54; 95% CI, 1.23-1.94) among individuals with 0 vs 5 risk factors. This association was consistent among several age strata and important patient subgroups. Among patients with incident acute myocardial infarction without prior cardiovascular disease, in-hospital mortality was inversely related to the number of coronary heart disease risk factors.
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影响因子：
24
作者：
Virmani, R;Burke, AP;Kolodgie, FD
通讯作者：
Kolodgie, FD
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Greenland, P;Knoll, MD;Wilson, PW
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Wiviott, SD;Morrow, DA;Braunwald, E
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