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冠心病与中风在发病率、病死率及危险因素方面存在差异,但在致死性和非致死性事件的危险因素方面差异较小。

Differences between coronary disease and stroke in incidence, case fatality, and risk factors, but few differences in risk factors for fatal and non-fatal events.

作者信息

Wilhelmsen Lars, Köster Max, Harmsen Per, Lappas Georg

机构信息

Section of Preventive Cardiology, The Cardiovascular Institute, Göteborg University, Drakegatan 6, SE-412 50 Göteborg, Sweden. lars.wilhelmsen#scri.se

出版信息

Eur Heart J. 2005 Sep;26(18):1916-22. doi: 10.1093/eurheartj/ehi412. Epub 2005 Jul 11.

Abstract

AIMS

To compare incidence and mortality of coronary and stroke events, and risk factors for non-fatal and fatal events, respectively.

METHODS AND RESULTS

Incidence and mortality were compared in all coronary (n=559 341) and stroke (n=530 689) events in Sweden from 1987 to 2001. Data from 28 years of follow-up of a random sample of 7400 men aged 47-55 and free of disease at baseline were used to compare risk factors. Incidence and 28 days of case fatality were considerably higher for coronary disease than for stroke, especially for men. Incidence of coronary disease decreased, especially for men (P=0.0001 for both sexes), and mortality declined for both men and women during 1987-2001 (P=0.0001 for both sexes). Stroke incidence declined slightly (P=0.0001 for both sexes), and there was a decline of mortality (P=0.0001 for both sexes). Out-of-hospital mortality during the first 28 days was higher than in-hospital mortality for coronary events, whereas for stroke, in-hospital mortality was higher (in men) or the same (in women) as out-of-hospital mortality. High serum cholesterol was a strong risk factor for coronary events, but not for stroke. High blood pressure was a stronger risk factor for stroke. About 50% of men with both stroke and coronary disease died from coronary disease.

CONCLUSION

Several differences regarding incidence, mortality, prognosis, and risk factors for stroke and coronary disease point towards different pathologies.

摘要

目的

分别比较冠心病和中风事件的发病率和死亡率,以及非致命和致命事件的危险因素。

方法与结果

比较了1987年至2001年瑞典所有冠心病(n = 559341)和中风(n = 530689)事件的发病率和死亡率。使用对7400名年龄在47 - 55岁且基线时无疾病的男性随机样本进行28年随访的数据来比较危险因素。冠心病的发病率和28天病死率显著高于中风,尤其是男性。在1987 - 2001年期间,冠心病发病率下降,尤其是男性(两性P = 0.0001),男性和女性的死亡率均下降(两性P = 0.0001)。中风发病率略有下降(两性P = 0.0001),死亡率也有所下降(两性P = 0.0001)。冠心病事件前28天的院外死亡率高于院内死亡率,而中风的院内死亡率更高(男性)或与院外死亡率相同(女性)。高血清胆固醇是冠心病事件的强危险因素,但不是中风的危险因素。高血压是中风的更强危险因素。约50%患有中风和冠心病的男性死于冠心病。

结论

中风和冠心病在发病率、死亡率、预后和危险因素方面的若干差异表明存在不同的病理情况。

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