[Sex specific trends of sudden cardiac death and acute myocardial infarction: results of the population-based KORA/MONICA-Augsburg register 1985 to 1998].
[Sex specific trends of sudden cardiac death and acute myocardial infarction: results of the population-based KORA/MONICA-Augsburg register 1985 to 1998].
复制标题
[心源性猝死和急性心肌梗塞的性别特定趋势：1985 年至 1998 年基于人口的 KORA/MONICA-Augsburg 登记结果]。
DOI：
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发表时间：
2002
影响因子：
0.6
通讯作者：
W. Koenig
中科院分区：
文献类型：
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作者：
H. Löwel;C. Meisinger;M. Heier;A. Hörmann;B. Kuch;J. Gostomzyk;W. Koenig
背景与目的
心肌梗死（MI）是成年人群死亡的主要单一原因。对于MONICA奥格斯堡人群，MI发病率、死亡率和28天病死率及其决定因素按性别进行了评估，并提出了加强急性护理计划的建议。
患者和方法
从1985年到1998年，登记了13499例25- 74岁的MI病例（9537例男性，3962例女性）; 7873例（5300例男性，2573例女性）在28天内死亡。心源性死亡由地区卫生部门确定;死亡原因由最后一位主治医生和验尸官确认（响应> 90%）。对住院患者进行关于急性事件的病史和情况的访谈;从医院图表中提取治疗数据。分别对入院前、入院后第1天和第2 ~ 28天进行分析。
结果
每10万人口MI发病率男性从560例降至397例，女性从161例降至145例;死亡率男性从317例降至232例，女性从101例降至96例。男性的下降是由于MI事件和复发的减少，而女性的下降仅是由于MI复发的减少。三分之一在住院前死亡，主要是在家中。住院第一天的病死率（CF）增加。在24小时存活者中，循证治疗显著增加，男性28天CF从13.0%降至8.4%，女性从12.5%降至10.7%。
结论
积极的危险因素管理和对有心血管危险因素的患者进行关于急性症状的教育以及使用急救系统，将因此提高人口的院前和28天生存率。
BACKGROUND AND AIM
Myocardial infarction (MI) is the main single cause of death in adult populations. For the MONICA Augsburg population, MI-morbidity, mortality, and 28-day case fatality and their determinants were assessed by gender, and suggestions for an intensified acute care program were presented.
PATIENTS AND METHODS
From 1985 to 1998, 13 499 25- to 74-year-old MI cases (9537 men, 3962 women) were registered; 7873 cases (5300 men, 2573 women) died within 28 days. Cardiac deaths were identified by regional health departments; causes of death were validated by the last treating physician and the coroner (response > 90 %). Hospitalized patients were interviewed about history and circumstances of the acute event; treatment data were abstracted from hospital charts. The prehospital phase, the first and the 2nd to 28thday after hospitalization were analyzed separately.
RESULTS
MI-morbidity per 100 000 population declined from 560 to 397 MI cases in men and from 161 to 145 in women; mortality decreased from 317 to 232 in men and from 101 to 96 in women. The decline in men was due to decreasing incident and recurrent MI whereas in women it was only due to a reduction of recurrent MI. One third died before hospitalization, mainly at home. Case fatality (CF) on the first day in hospital increased. In 24 hour survivors, evidence based treatment increased considerably, and was accompanied by decreasing 28-day-CF from 13.0 % to 8.4 % in men, and from 12.5 % to 10.7 % in women.
CONCLUSION
Aggressive risk factor management and education of patients with cardiovascular risk factors concerning acute symptoms and the use of the emergency system will consequently improve pre-hospital and 28-day survival of the population.