A Study on The Trend of The Incidence and Fatality Rates and Factors Related to Development of Ischemic Heart Disease and Sudden Death

为了了解新潟市和长冈市急性心肌梗死（AMI）和猝死的发病率和死亡率，我们构建了一个登记系统。在1994年4月至1995年3月期间，只要发生15至65岁的病例，主治医生就会将其通知登记办公室，并由负责的医生审查病历。只有根据MONICA标准确诊为急性心肌梗塞的病例或24小时内死亡的猝死病例被登记。为了检查登记率，所有的死亡证明都被分开检查。一名训练有素的护士对病人本人或死者家属进行了访谈，以获取所有病例的信息。对在一家机构接受健康检查的544名对照受试者进行了同样的访谈。共登记急性心肌梗死70例（幸存者67例，发病24小时内死亡3例）和猝死83例。图表回顾显示，登记的猝死病例中有7.5%死于AMI。死亡证明检查中，AMI 3例，猝死154例。根据这些病例数估计的AMI病例总数，AMI的年发病率为17.1/10万人（45-65岁年龄组为39.5/10万人）。循环系统疾病多见于猝死病例，冠状动脉危险因素多见于AMI病例。两组患者在发病前1周内出现的自主神经系统相关症状如异常排汗、冷热感觉等更为频繁。与AMI组相比，猝死组有更大的每日劳动负荷和更高的睡眠时间减少率。只在急性心肌梗死病例中才经常出现抱怨压力的病例。

To elucidate the incidence and mortality rates of acute myocardial infarction (AMI) and sudden death in Niigata and Nagaoka cities, we constructed a registration system. Whenever a case, aged 15 to 65 years, occurred from April, 1994 to March, 1995, the attending physician notified it to the registry office and a doctor in charge reviewed medical charts. Only the cases confirmed as definite AMI according to MONICA criteria or as sudden death defined as death within 24 houes were registered. To check the registration rate, all death certificates were inspected separately. An interview with the patient himself or deceased family was done by a trained nurse to obtain information on all cases. The same interview was done with the 544 control subjects who received health check-up in an institute. 70 cases of AMI (survivor cases : 67, cases which died later than 24 hours from the occurrence : 3) and 83 sudden death cases were registeres. Chart review revealed that 7.5% of the registered sudden death cases died from AMI.In the death certificate inspection, there were 3 AMI cases and 154 sudden death cases. Based on the total number of AMI cases estimated from these case numbers, the annual incidence rate for AMI was 17.1/100,000 population (39.5/100,000 for the age group 45-65 years). Diseases of circulatory system were more frequently seen in sudden death cases and coronary risk factors, in AMI cases. Symptomes related to autonomic nervous system such as sbnormal perspiratio and hot and cold feelings appeared more frequently in both case groups during one week before disease occurrence. Sudden death group had a greater daily labor load and a higher rate of those who had decrease in sleeping hours during that week than the AMI group. Cases who complained of stress were frequent only in the AMI cases.