Tu Jack V, Austin Peter C, Filate Woganee A, Johansen Helen L, Brien Susan E, Pilote Louise, Alter David A
Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada.
Can J Cardiol. 2003 Jul;19(8):893-901.
Little information is available on recent population-based trends in the outcomes of patients who have had an acute myocardial infarction (AMI) in Canada.
Data were analyzed from the Discharge Abstract Database and Hospital Morbidity Database of the Canadian Institute for Health Information. All new cases of AMI in Canada between fiscal 1997/98 and fiscal 1999/2000 of patients at least 20 years old were examined. Data were also analyzed from these databases for hospital readmissions for a second AMI, angina and congestive heart failure (CHF).
There were 139,523 new AMI cases. The overall crude in-hospital AMI mortality rate in Canada was 12.3%. In-hospital mortality rate after an AMI was worse for women than for men in Canada (16.7% and 9.9%, respectively). The age- and sex-standardized in-hospital mortality rate varied from a low of 10.5% (95% CI 8.4% to 12.6%) in Prince Edward Island to a high of 13.1% (95% CI 12.8% to 13.5%) in Quebec. Among AMI survivors, 12.5% were readmitted within one year for angina, 7.7% for a second AMI and 7.5% for CHF. There were wide interregional differences in age- and sex-standardized mortality rates and one-year readmission rates.
AMI is associated with a substantial acute mortality rate in Canada, especially in the elderly and female patients. Identifying the causes of interregional differences in patient outcomes should be a priority for future research.
关于加拿大近期基于人群的急性心肌梗死（AMI）患者预后趋势的信息较少。
对加拿大卫生信息研究所的出院摘要数据库和医院发病率数据库中的数据进行分析。研究了1997/98财政年度至1999/2000财政年度加拿大所有至少20岁的AMI新发病例。还从这些数据库中分析了因第二次AMI、心绞痛和充血性心力衰竭（CHF）而再次住院的数据。
共有139,523例AMI新发病例。加拿大AMI患者总体粗住院死亡率为12.3%。在加拿大，AMI后的住院死亡率女性高于男性（分别为16.7%和9.9%）。年龄和性别标准化住院死亡率从爱德华王子岛的低至10.5%（95%CI 8.4%至12.6%）到魁北克的高至13.1%（95%CI 12.8%至13.5%）不等。在AMI幸存者中，12.5%在一年内因心绞痛再次住院，7.7%因第二次AMI再次住院，7.5%因CHF再次住院。年龄和性别标准化死亡率及一年再入院率存在较大的地区间差异。
在加拿大，AMI与相当高的急性死亡率相关，尤其是在老年患者和女性患者中。确定患者预后地区间差异的原因应是未来研究的重点。
