Madsen M, Rasmussen S, Juel K
Statens Institut for Folkesundhed, København.
Ugeskr Laeger. 2000 Oct 30;162(44):5918-23.
The paper describes the epidemiology of acute myocardial infarction in Denmark. The study provides statistics on mortality, incidence and case-fatality for 1996 and the time trend since 1978. The results are compared to the results from the international MONICA study.
The analyses are based on national population-based registers on causes of death and hospital admissions.
The mortality from ischaemic heart disease has declined considerably. The study confirms that the decline in mortality can be ascribed to a decrease in incidence as well as a decrease in case fatality. In the period 1985-1996 the incidence decreased by 3.5% per year for men and 2.5% for women. Mortality rates within 28 days after admission to hospital with MI was almost constant until 1988 following which there was a significant drop. Despite the improved prognosis for MI patients, one quarter die before admission to hospital, and one quarter die within one year after an MI.
The incidence rates of MI based on the national population-based registers are consistent with the results from the Danish MONICA study. The reduction in incidence rates is a little smaller than the results in the Danish part of the MONICA study, whereas the marked reduction in case-fatality found in this study is not in agreement with the results from MONICA. This discrepancy is not yet understood. The declining trend in case fatality started in 1988 and may be related to the introduction of thrombolysis and acetylsalcylic acid treatment.
本文描述了丹麦急性心肌梗死的流行病学情况。该研究提供了1996年的死亡率、发病率和病死率统计数据以及自1978年以来的时间趋势。研究结果与国际MONICA研究的结果进行了比较。
分析基于全国人口死因登记和住院登记。
缺血性心脏病的死亡率大幅下降。该研究证实，死亡率的下降可归因于发病率的降低以及病死率的降低。在1985 - 1996年期间，男性发病率每年下降3.5%，女性下降2.5%。因心肌梗死入院后28天内的死亡率在1988年之前几乎保持不变，此后显著下降。尽管心肌梗死患者的预后有所改善，但仍有四分之一的患者在入院前死亡，四分之一的患者在心肌梗死后一年内死亡。
基于全国人口登记得出的心肌梗死发病率与丹麦MONICA研究的结果一致。发病率的下降幅度略小于MONICA研究丹麦部分的结果，而本研究中病死率的显著下降与MONICA的结果不一致。这种差异尚不清楚。病死率的下降趋势始于1988年，可能与溶栓治疗和乙酰水杨酸治疗的引入有关。
