A 25-year perspective into the changing landscape of patients hospitalized with acute myocardial infarction (the Worcester Heart Attack Study)
A 25-year perspective into the changing landscape of patients hospitalized with acute myocardial infarction (the Worcester Heart Attack Study)
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DOI：
10.1016/j.amjcard.2004.07.142
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发表时间：
2004-12-01
影响因子：
2.8
通讯作者：
Dalen, JE
中科院分区：
文献类型：
--
作者：
Goldberg, RJ;Spencer, FA;Dalen, JE
在过去的几十年里，冠状动脉疾病的一级和二级预防取得了重大进展。然而，改变生活方式和治疗方法对急性心肌梗死（AMI）患者的人口学和临床概况以及医院预后的影响尚未得到很好的表征。我们开展了一项前瞻性的基于人群的调查，研究了25年（1975年至2001年）急性心肌梗死住院患者的人口学、临床特征、治疗方法和住院结果的趋势。在1975年至2001年的13个1年期间，在伍斯特所有大医院因确诊AMI住院的大都会地区（马萨诸塞州伍斯特）居民（n = 10,440）构成了感兴趣的样本。在最近的研究期间住院的患者明显年龄较大，更有可能是女性，并且合并症的患病率更高。在调查期间，住院患者越来越有可能接受有效的心脏药物治疗和冠状动脉介入治疗。随着时间的推移，多变量调整后的住院生存率显著提高，而在几种重要临床并发症的发生中观察到不同的趋势。目前的结果为AMI住院患者的变化特征、治疗实践及其短期结果提供了见解。鉴于急性心肌梗死的严重程度和不断发展的管理方法，继续监测这些趋势仍然具有相当大的临床和公共卫生重要性。(C) 2004年由摘录医疗公司。
over the past several decades, significant advances have been made in the primary and secondary prevention of coronary artery disease. However, effects of changing lifestyle and treatment practices on demographic and clinical profiles and on hospital outcomes of patients who present with acute myocardial infarction (AMI) have not been well characterized. We carried out a prospective population-based investigation of >25-year trends (1975 to 2001) in demographic and clinical characteristics, treatment practices, and hospital outcomes of patients who had been hospitalized with AMI. Residents of a metropolitan area (Worcester, Massachusetts) who had been hospitalized with validated AMI (n = 10,440) in all greater Worcester hospitals during thirteen 1-year periods between 1975 and 2001 comprised the sample of interest. Patients who had been hospitalized during the most recent study years were significantly older, were more likely to be women, and had a greater prevalence of co-morbidifies. Hospitalized patients were increasingly more likely to receive effective cardiac medications and coronary interventions over the period under investigation. Multivariable-adjusted hospital survival rates improved considerably over time, whereas different trends were observed in the occurrence of several important clinical complications. The present results provide insights into the changing characteristics of patients who are hospitalized with AMI, treatment practices, and their short-term outcomes. Given the magnitude of AMI and evolving approaches to manage it, continued monitoring of these trends remains of considerable clinical and public health importance. (C) 2004 by Excerpta Medica Inc.