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[以色列急性心肌梗死患者的危险因素构成:2000年以色列急性心肌梗死全国前瞻性调查的亚分析]

[Composition of risk factors among acute myocardial infarction patients in Israel: sub-analysis of the Israeli National Prospective Survey on Acute Myocardial Infarction in 2000].

作者信息

Elis Avishay, Lishner Michael

机构信息

Department of Medicine A, Meir Hospital, Kfar Saba, Israel.

出版信息

Harefuah. 2004 Jul;143(7):479-81, 551, 550.

Abstract

BACKGROUND

Risk factor modification has been shown to reduce cardiovascular morbidity and mortality. Nevertheless, there is a debate regarding the relative importance of risk factors when analyzed by age, gender and ethnical background. The aim of the study was to define sub-populations with different classes of risk factors that may enable targeted and improved preventive approaches.

METHODS

The study is a sub-analysis of the Israeli National Prospective Survey on Acute Myocardial Infarction in the year 2000. We evaluated the interactions between the classical risk factors and their correlation with the patients' age and gender.

RESULTS

A total of 1,683 patients with acute myocardial infarction were hospitalized in 26 hospitals in Israel during February and March 2000. Seventy-three percent were men and 27% were women and their mean age was 66 +/- 13 years. Younger patients had significantly more risk factors than the older ones (P < or = 0.0001). Women were significantly older and had less risk factors than males (73 +/- 12 vs. 63 +/- 14, P < 0.01; 2.02 +/- 1.10 vs. 1.84 +/- 1.03, P < or = 0.002, respectively). One hundred and twenty-eight patients (7.8%) had no risk factors. Hyperlipidemia, current smoking and family history were common in younger patients, while hypertension and diabetes mellitus were more common in the older ones. Family history and smoking were significantly more common in males, whereas diabetes mellitus and hypertension were more common in females.

CONCLUSIONS

There were defined sub-populations with different risk factors for acute myocardial infarction. Our findings suggest that in young patients cessation of smoking and control of hyperlipidemia are of crucial importance. Hypertension and diabetes mellitus are more common in women and older patients and their impact on the atherosclerotic process is gradual and manifests later in life. Further studies should clarify the relative importance of each risk factor and its control.

摘要

背景

已证实改变危险因素可降低心血管疾病的发病率和死亡率。然而,在按年龄、性别和种族背景分析时,关于危险因素的相对重要性存在争议。本研究的目的是确定具有不同类别危险因素的亚人群,这可能有助于采取有针对性的、改进的预防措施。

方法

本研究是对2000年以色列全国急性心肌梗死前瞻性调查的一项子分析。我们评估了经典危险因素之间的相互作用及其与患者年龄和性别的相关性。

结果

2000年2月至3月期间,以色列26家医院共收治了1683例急性心肌梗死患者。其中73%为男性,27%为女性,平均年龄为66±13岁。年轻患者的危险因素明显多于老年患者(P≤0.0001)。女性年龄明显较大,危险因素比男性少(分别为73±12岁和63±14岁,P<0.01;2.02±1.10和1.84±1.03,P≤0.002)。128例患者(7.8%)无危险因素。高脂血症、当前吸烟和家族史在年轻患者中常见,而高血压和糖尿病在老年患者中更常见。家族史和吸烟在男性中明显更常见,而糖尿病和高血压在女性中更常见。

结论

确定了急性心肌梗死具有不同危险因素的亚人群。我们的研究结果表明,对于年轻患者,戒烟和控制高脂血症至关重要。高血压和糖尿病在女性和老年患者中更常见,它们对动脉粥样硬化进程的影响是渐进的,在生命后期才显现出来。进一步的研究应阐明每个危险因素的相对重要性及其控制方法。

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