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首次心肌梗死后一年死亡率的性别差异。

Sex differences in one-year mortality after a first-ever myocardial infarction.

作者信息

Rastenyte Daiva, Jancaityte Lina

机构信息

Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 50161 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2005;41(9):754-9.

Abstract

OBJECTIVES

To determine the significance of sex in one-year prognosis of death from ischemic heart disease after a first-ever myocardial infarction.

MATERIAL AND METHODS

Kaunas men and women aged 25-64 years and admitted to the hospitals of Kaunas due to a first-ever myocardial infarction during 1983-1992, and with a first coded electrocardiogram were enrolled into the study. Electrocardiograms were analyzed using the criteria of the Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Project of World Health Organization (WHO) and the Minnesota Code. The Kaunas ischemic heart disease register was a source of data.

RESULTS

Women with a Q-wave or non-Q-wave myocardial infarction were older; they had anterior localization of myocardial infarction, a history of diabetes and obesity more frequently than men. Myocardial infarction was more often complicated by atrial flutter or fibrillation (p=0.02) in women with Q-wave myocardial infarction than in men, and women with non-Q-wave myocardial infarction more frequently had history of hypertension than men (p=0.00). One-year mortality after a myocardial infarction was significantly higher in women with Q-wave myocardial infarction than in women with non-Q-wave myocardial infarction (p=0.03). There was no difference in odds to die during a first year after myocardial infarction with or without Q-wave between women and men neither in univariate nor in multivariate analysis.

CONCLUSIONS

Women aged 25 to 64 years had similar crude risk of dying during one year after initial myocardial infarction compared with men of the same age group. There were no statistically significant differences between men and women with Q-wave or non-Q-wave myocardial infarction after adjustment for potential confounders.

摘要

目的

确定性别在首次心肌梗死后缺血性心脏病一年死亡预后中的意义。

材料与方法

纳入1983年至1992年因首次心肌梗死入住考纳斯医院、年龄在25 - 64岁且有首次编码心电图的考纳斯男性和女性。使用世界卫生组织(WHO)心血管疾病监测趋势和决定因素(MONICA)项目的标准以及明尼苏达编码对心电图进行分析。考纳斯缺血性心脏病登记册是数据来源。

结果

发生Q波或非Q波心肌梗死的女性年龄更大;她们心肌梗死的部位更多在前方,糖尿病和肥胖病史比男性更常见。Q波心肌梗死女性发生心房扑动或颤动的心肌梗死并发症比男性更常见(p = 0.02),非Q波心肌梗死女性高血压病史比男性更常见(p = 0.00)。Q波心肌梗死女性心肌梗死后一年死亡率显著高于非Q波心肌梗死女性(p = 0.03)。在单因素和多因素分析中,无论有无Q波,女性和男性心肌梗死后第一年死亡的几率均无差异。

结论

25至64岁女性在初次心肌梗死后一年内的粗死亡风险与同年龄组男性相似。在对潜在混杂因素进行调整后,有Q波或非Q波心肌梗死的男性和女性之间无统计学显著差异。

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