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

为了解新泻市和长冈市的急性心肌梗死和猝死的发病率和死亡率，我们建立了一个登记系统。从1994年4月至1995年3月，每当15岁至65岁的病例发生时，主治医生都会将其通知登记处，并由一名主管医生审查病历。按Monica标准确诊为急性心肌梗死或猝死定义为24个院内死亡的病例登记在案。为了检查登记率，所有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面谈，以获取所有病例的信息。同样的访谈是对在某研究所接受健康检查的544名对照受试者进行的。入选急性心肌梗死70例(存活67例，发病后24小时内死亡3例)，猝死83例。查图显示，登记的猝死病例中有7.5%死于急性心肌梗死，在死亡证明查阅中，有3例急性心肌梗死，154例猝死。根据这些病例估计的急性心肌梗死病例总数，急性心肌梗死的年发病率为17.1/10万人口(45-65岁年龄组为39.5/10万)。循环系统疾病多见于猝死病例和急性心肌梗死患者中的冠状动脉危险因素。两组患者在发病前一周内均出现与自主神经系统有关的症状，如正常出汗、冷热等。猝死组与急性心肌梗塞组相比，每天的工作量更大，睡眠时间减少的比率也更高。主诉应激的病例仅见于急性心肌梗死患者。

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.