Ciruzzi Mario A, Schargrosky Herman, Pramparo Palmira, Rosloznik Jorge, Zylbersztejn Horacio, Haquim Mónica, Rudich Viviana, Caccavo Alberto, Piskorz Daniel
Medicina (B Aires). 2002;62(6):535-43.
This case-control study, analyzed the role of coronary risk factors in acute myocardial infarction (AMI) in the elderly, and established the nature of this association and the degree of risk. Data were derived from an investigation (1060 cases and 1071 controls) conducted in 35 coronary care units from clinical centres in Argentina between November 1991 and August 1994. Our analysis was based on data collected from subjects over age 65. Cases were 427 patients with AMI and without history of ischaemic heart disease. Controls were 396 subjects identified in the same centres as the cases. Odds ratios (OR) estimates and their 95% confidence intervals (CI) were derived from multiple logistic regression equations including terms for age, education, social status, smoking status, history of diabetes or hypertension, body mass index and family history of coronary heart disease. The risk factors independently and strongly related to the risk of AMI were the following: hyperlipidemia (serum cholesterol > or = 240 mg/dl): OR = 1.76 (95% CI: 1.25-2.49), smoking habits: OR = 1.6 (95% CI: 1.06-2.4), hypertension: OR = 2.05 (95% CI: 1.51-2.73), diabetes OR = 1.71 (95% CI: 1.12-2.70), one relative with family history of coronary heart disease: OR = 1.36 (95% CI: 0.93-1.97) and two or more relatives: OR = 2.63 (95% CI: 1.21-5.71). This study confirms in the elderly the importance of hyperlipidemia, tobacco, hypertension, diabetes and family history of coronary heart disease as risks factors of AMI.
这项病例对照研究分析了冠状动脉危险因素在老年人急性心肌梗死(AMI)中的作用,并确定了这种关联的性质和风险程度。数据来源于1991年11月至1994年8月在阿根廷临床中心的35个冠心病监护病房进行的一项调查(1060例病例和1071例对照)。我们的分析基于从65岁以上受试者收集的数据。病例为427例急性心肌梗死患者,无缺血性心脏病病史。对照是在与病例相同的中心确定的396名受试者。比值比(OR)估计值及其95%置信区间(CI)来自多元逻辑回归方程,包括年龄、教育程度、社会地位、吸烟状况、糖尿病或高血压病史、体重指数和冠心病家族史等项。与急性心肌梗死风险独立且密切相关的危险因素如下:高脂血症(血清胆固醇≥240mg/dl):OR = 1.76(95%CI:1.25 - 2.49),吸烟习惯:OR = 1.6(95%CI:1.06 - 2.4),高血压:OR = 2.05(95%CI:1.51 - 2.73),糖尿病OR = 1.71(95%CI:1.12 - 2.70),有一位冠心病家族史的亲属:OR = 1.36(95%CI:0.93 - 1.97),两位或更多亲属:OR = 2.63(95%CI:1.21 - 5.71)。这项研究证实了在老年人中高脂血症、烟草、高血压、糖尿病和冠心病家族史作为急性心肌梗死危险因素的重要性。