Trends from 1987 to 2004 in sudden death due to coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study.
Trends from 1987 to 2004 in sudden death due to coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study.
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DOI：
10.1016/j.ahj.2008.08.016
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发表时间：
2009-01
影响因子：
4.8
通讯作者：
Sorlie, Paul D.
中科院分区：
文献类型：
--
作者：
Ni, Hanyu;Coady, Sean;Rosamond, Wayne;Folsom, Aaron R.;Chambless, Lloyd;Russell, Stuart D.;Sorlie, Paul D.
关于美国社区冠心病(CHD)猝死的长期变化的数据很少。我们使用社区动脉粥样硬化风险研究(ARIC)的数据，研究了1987至2004年间冠心病猝死的趋势。使用死亡证明、举报人和验尸官访谈以及医生裁决等多种来源，确定了四个社区35-74岁居民的冠心病猝死。在调整了人口因素后，用泊松回归分析了1987-1989年、1990-1992年、1993-1995年、1996-98年、1999-2001年、2002-2004年这六个时期的趋势。总体而言，32.6%的冠心病死亡是突然的，发生在症状出现后一小时内，其中63.5%的人之前没有被诊断为冠心病。对于女性来说，有冠心病病史的猝死降低了40%(P=0.059)，没有冠心病病史的猝死降低了27%(P=0.067)，非猝死降低了39%(P<；0.001)。这一趋势并不因社区而异。对于男性，有和没有冠心病病史的猝死的趋势不同(交互作用的Ps分别为0.019和0.009)，但非猝死的趋势不同(交互作用的P=0.1)。在所有社区中，有冠心病病史的男性猝死的下降幅度最大(58%，P<；0.001)，其次是非冠心病猝死(39%，P<；0.001)和无冠心病病史的猝死(31%，P=0.002)。然而，随着时间的推移，冠心病猝死的比例保持稳定。尽管有和没有冠心病病史的冠心病猝死率随着时间的推移而下降，但趋势模式可能因社区和性别而不同。
Few data are available on the secular changes in sudden coronary heart disease (CHD) death in U.S. communities. We examined trends in sudden CHD death from 1987 to 2004, using data from the Atherosclerosis Risk in Communities (ARIC) study. Sudden CHD deaths in residents aged 35–74 years of four communities were ascertained using multiple sources such as death certificates, informant and coroner interviews, and physician adjudications. Poisson regression was used to assess the trends for the six time periods: 1987–1989, 1990–1992, 1993–1995, 1996–98, 1999–2001, 2002–2004, after adjusting for demographic factors. Overall, 32.6% of CHD deaths were sudden, occurring within an hour after the onset of symptoms, 63.5% of which had no prior diagnosis of CHD. For women, the rate declined by 40% (P=0.059) for sudden deaths with CHD history, 27% (P=0.067) for those without CHD history, and 39% (P<0.001) for non-sudden CHD deaths. The trends did not differ by community. For men, the trends differed by community for sudden deaths with and without CHD history (Ps for the interaction=0.019 and 0.009, respectively) but not for non-sudden CHD death (P for the interaction=0.10). For all communities combined, the decline in men was greatest for sudden deaths with CHD history (by 58%, P<0.001), followed by non-sudden CHD deaths (by 39%, P<0.001) and sudden deaths without CHD history (by 31%, P=0.002). However, the proportion of CHD deaths that were sudden had remained stable over time. Although the rate of sudden CHD deaths, with and without CHD history, declined over time, the trend pattern may differ by community and gender.
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