SUDDEN-DEATH RISK IN OVERT CORONARY HEART-DISEASE - THE FRAMINGHAM-STUDY
SUDDEN-DEATH RISK IN OVERT CORONARY HEART-DISEASE - THE FRAMINGHAM-STUDY
复制标题
DOI：
10.1016/0002-8703(87)90722-8
复制
发表时间：
1987-03-01
影响因子：
4.8
通讯作者：
DAGOSTINO, RB
中科院分区：
文献类型：
--
作者：
KANNEL, WB;CUPPLES, LA;DAGOSTINO, RB
对5127例无冠心病者进行了30年的监测，发现760例男性和574例女性发生了显性冠心病，其中男性猝死160例，女性猝死73例。在那些持续临床表现的CHD患者中，猝死风险是那些没有中期事件的患者的6.7倍。虽然相对风险在两个性别是可比的，冠心病并没有消除女性对男性的优势。心肌梗死比心绞痛有更大的猝死风险，无症状性梗死与症状性梗死同样危险。冠心病的发作使年轻人和老年人面临同样的猝死风险。大约40%的猝死发生在4%的患有明显CHD的普通人群中。以猝死表现的冠状动脉发作比例从35 - 64岁的13%增加到65 - 94岁的20%。冠心病猝死的比例在有冠心病的人群中低于无冠心病的人群。在冠心病患者中，缺血性心肌损害和心力衰竭是猝死的主要预测因素。在过去的30年里，尽管全国的总体CHD死亡率有所下降，但既往CHD受试者中以猝死形式出现的CHD死亡比例并未下降。
Over 30 years of surveillance of 5127 subjects free of CHD, 760 men and 574 women developed overt CHD, and there were 160 sudden deaths in men and 73 in women. Among those who sustained clinically manifest CHD, the sudden death risk was increased 6.7 times that of those without an interim event. Although the relative risk was comparable in the two sexes, CHD did not eliminate the female advantage over men. Myocardial infarction imposed a greater sudden death risk than angina pectoris, and silent infarctions were as dangerous as symptomatic infarctions. Onset of CHD put young and old at equal risk of sudden death. Some 40% of sudden deaths occurred in the 4% of the general population with overt CHD. The proportion of coronary attacks presenting as sudden death increased from 13% at ages 35 to 64 years to 20% at ages 65 to 94 years. The fraction of CHD deaths classified as sudden deaths was lower in those with than without iterim CHD. In those with established CHD, factors reflecting ischemic myocardial damage and cardiac failure were the chief predictors of sudden death. The proportion of CHD deaths presenting as sudden deaths has not declined in subjects with prior CHD over three decades, despite a national decline in the overall CHD mortality rate.