Mak K-H, Chia K-S, Kark J D, Chua T, Tan C, Foong B-H, Lim Y-L, Chew S-K
Department of Cardiology, National Heart Centre, Singapore.
Eur Heart J. 2003 Jan;24(2):151-60. doi: 10.1016/s0195-668x(02)00423-2.
We compare the myocardial infarction (MI) event and mortality rates among Chinese, Malay and Indian residents of Singapore.
Residents, aged 20 to 64 years, with an MI event were identified from hospital discharge listings, postmortem reports, and the Registry of Births and Deaths. All pathology laboratories flagged patients with elevated creatine phosphokinase (CPK) levels. Modified MONICA (multinational monitoring of trends and determinants in cardiovascular disease) criteria were used for determining MI events.
From 1991 to 1999, 12 481 MI events were identified. Chinese patients were older and less likely to have typical symptoms or previous MI. Malays had the highest peak CPK level. Among all three ethnic groups, MI event and age-adjusted case-fatality rates declined. Compared with Chinese, MI event rates were >2-fold and >3-fold higher, and age-standardized coronary mortality rates were 2.4 and 3.0 higher times for Malays and Indians, respectively. Malays have the highest 3.1-year case-fatality, with an adjusted hazard ratio of 1.26 (95% confidence interval, 1.14 to 1.38) compared with Chinese.
We found strong ethnic differences in MI event, case-fatality and coronary mortality rates among the three ethnic groups in Singapore. While Indians have the greatest MI event rates, Malays have the highest case-fatality.
我们比较了新加坡华裔、马来裔和印度裔居民中心肌梗死（MI）事件及死亡率。
从医院出院清单、尸检报告以及出生和死亡登记处中识别出年龄在20至64岁之间发生MI事件的居民。所有病理实验室都标记了肌酸磷酸激酶（CPK）水平升高的患者。采用改良的MONICA（心血管疾病趋势和决定因素多国监测）标准来确定MI事件。
1991年至1999年期间，共识别出12481例MI事件。华裔患者年龄较大，出现典型症状或既往有MI的可能性较小。马来裔患者的CPK峰值水平最高。在所有三个种族群体中，MI事件及年龄调整后的病死率均有所下降。与华裔相比，马来裔和印度裔的MI事件发生率分别高出2倍多和3倍多，年龄标准化的冠心病死亡率分别高出2.4倍和3.0倍。马来裔的3.1年病死率最高，与华裔相比，调整后的风险比为1.26（95%置信区间，1.14至1.38）。
我们发现新加坡三个种族群体在MI事件、病死率和冠心病死亡率方面存在显著的种族差异。虽然印度裔的MI事件发生率最高，但马来裔的病死率最高。
