Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial Q-wave and non-Q-wave myocardial infarction: A multi-hospital community-wide perspective
Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial Q-wave and non-Q-wave myocardial infarction: A multi-hospital community-wide perspective
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DOI：
10.1016/s0735-1097(01)01203-7
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发表时间：
2001-05-01
影响因子：
24
通讯作者：
Gore, JM
中科院分区：
文献类型：
--
作者：
Furman, MI;Dauerman, HL;Gore, JM
目的本研究的目的是检查发病率的长期趋势，初始非Q波心肌梗死（NQMI）患者与初始Q波心肌梗死（QMI）患者相比的院内和长期死亡率模式。背景有限的数据描述了来自多医院社区的初始QMI和NQMI的发病率和死亡率趋势-方法：我们的研究是一项对5,832名马萨诸塞州伍斯特市居民的观察性研究（1990年人口普查= 437人，1975年至1997年间的11个年度期间，所有大伍斯特医院因经验证的初始急性心肌梗死住院。结果1975年至1997年间，QWMI的发生率逐渐下降。78（发病率= 171/100，000人口）和1997（101/100，000人口）。与此相反，NQARNIA的发病率在1975/78年（62/100，000人口）至1997年（131/100，000人口）期间逐渐增加。住院死亡率为19.5%的患者与QALY和12.5%的患者与NQALY。在控制了各种协变量后，QALY患者的住院死亡风险仍显著增加（校正比值比= 1.63; 95%置信区间：1.35，1.97）。虽然QALO的住院死亡率随着时间的推移逐渐下降（1975/78 = 24%; 1997 = 14%），但NQALO的住院死亡率保持不变（1975/78 = 12%; 1997 = 12%）。在调整潜在的混杂预后因素后，这些趋势仍然存在。出院后的多变量调整后的两年死亡率下降，随着时间的推移与QRISK和NQRISK.CONCLUSIONS患者尽管令人印象深刻的发病率下降，在医院和长期死亡率与QRISK，NQRISK是增加的频率，并有相同的住院死亡率，现在，因为它没有22年前。（美国科尔心脏病学杂志2001;37：1571-80）（C）2001年美国心脏病学会。
OBJECTIVE The goal of this study was to examine long-term trends in the incidence, in-hospital and long-term mortality patterns in patients with an initial non-Q-wave myocardial infarction (NQWMI) as compared with those with an initial Q-wave myocardial infarction (QWMI).BACKGROUND Limited data are available describing trends in the incidence and mortality from an initial QWMI and NQWMI from a multi-hospital community-wide perspective.METHODS Our study was an observational study of 5,832 metropolitan Worcester, Massachusetts residents (1990 census = 437,000) hospitalized with validated initial acute MI in all greater Worcester hospitals during 11 annual periods between 1975 and 1997.RESULTS The incidence of QWMI progressively decreased between 1975/78 (incidence rate = 171/100,000 population) and 1997 (101/100,000 population). In contrast, the incidence of NQWMI progressively increased between 1975/78 (62/100,000 population) and 1997 (131/100,000 population). Hospital death rates were 19.5% for patients with QWMI and 12.5% for those with NQWMI. After controlling for various covariates, patients with QWMI remained at significantly increased risk for hospital mortality (adjusted odds ratio = 1.63; 95% confidence interval: 1.35, 1.97). While the hospital mortality of QWMI has progressively declined over time (1975/78 = 24%; 1997 = 14%), the in-hospital mortality for NQWMI has remained the same (1975/78 = 12%; 1997 = 12%). These trends remained after adjusting for potentially confounding prognostic factors. The multivariable adjusted two-year mortality after hospital discharge declined over time for patients with QWMI and NQWMI.CONCLUSIONS Despite impressive declines in the incidence, in-hospital and long-term mortality associated with QWMI, NQWMI is increasing in frequency and has the same in-hospital mortality now as it did 22 years ago. (J Am Coll Cardiol 2001;37:1571-80) (C) 2001 by the American College of Cardiology.