Incidence of recognized and unrecognized myocardial infarction in men and women aged 55 and older: the Rotterdam Study
Incidence of recognized and unrecognized myocardial infarction in men and women aged 55 and older: the Rotterdam Study
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DOI：
10.1093/eurheartj/ehi707
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发表时间：
2006-03-01
影响因子：
39.3
通讯作者：
Witteman, JCM
中科院分区：
文献类型：
--
作者：
de Torbal, A;Boersma, E;Witteman, JCM
目的 关于 55 岁及以上受试者中未识别的心肌梗死 (MI) 发生率的当代数据有限。 方法和结果 我们在鹿特丹研究中研究了已识别和未识别的心肌梗死 (MI) 的发生率，该研究是一项基于人群的 55 岁及以上男性和女性队列。基线检查于1990-93年进行，后续检查于1994-95年和1997-2000年进行。通过模块化心电图分析系统分析基线和后续 12 导联心电图。 5148 名没有普遍梗塞证据的参与者作为分析对象。事件识别的梗死被定义为根据国际疾病分类第 10 版编码为 121 的致命或非致命事件的发生。 4187 名受试者可重复进行心电图检查。如果在没有临床识别事件的情况下有心电图证据，则认为发生了未识别的梗塞。在中位随访 6.4 年期间，发生了 141 起梗塞事件，该事件的发生率为每 1000 人年 5.0 起。男性的发病率（8.4）高于女性（3.1）。未被识别的梗塞发生率为每1000人年3.8例。男性（4.2）和女性（3.6）的发病率大致相似。因此，男性（33%）未识别梗塞的比例低于女性（54%）。未识别的梗死比例的这种差异与年龄无关。 结论 很大一部分心梗事件在临床上仍未被识别。由于 MI 病史与重复心血管并发症的风险增加相关，因此我们的数据表明，需要定期进行心电图筛查，以识别（流行的）梗塞，并在 55 岁及以上的人群中采取有效的预防性治疗。
Aims Contemporary data on the incidence of unrecognized myocardial infarction (MI) among subjects aged 55 and older are limited.Methods and results We studied the incidence of recognized and unrecognized MI in the Rotterdam Study, a population-based cohort of men and women aged 55 and older. The baseline examination was performed during 1990-93, with follow-up examinations during 1994-95, and 1997-2000. Baseline and follow-up 12-lead ECGs were analysed by the Modular ECG Analysis System. The 5148 participants who had no evidence of prevalent infarction were the subjects for analysis. Incident recognized infarction was defined as the occurrence of a fatal or non-fatal event coded as 121 according to the International Classification of Diseases, 10th edition. A repeat ECG was available in 4187 subjects. An unrecognized infarction was considered to have occurred if there was electrocardiographic evidence in the absence of a clinically recognized event. During a median follow-up of 6.4 years, 141 incident recognized infarctions occurred and the incidence rate of this event was 5.0 per 1000 person years. The incidence was higher in men (8.4) than in women (3.1). The incidence rate of unrecognized infarction was 3.8 per 1000 person years. Men (4.2) and women (3.6) had approximately similar incidence. Hence, the proportion of unrecognized infarction was lower in men (33%) than in women (54%). This difference in proportion of unrecognized infarctions was independent of age.Conclusion A high proportion of incident MIs remains clinically unrecognized. As a history of MI is associated with an increased risk of repeat cardiovascular complications, our data suggest a need for periodical electrocardiographic screening to recognize (prevalent) infarctions and to install effective preventive treatment in those aged 55 and older.