Barchielli Alessandro, Balzi Daniela, Pasqua Alessandro, Buiatti Eva
Unità di epidemiologia, Azienda sanitaria 10, Firenze.
Epidemiol Prev. 2006 May-Jun;30(3):161-8.
The Acute Myocardial Infarction Regional Registry of Tuscany was aimed to assess incidence and prognosis of acute myocardial infarction (AMI) in Tuscany, and the spread of interventional cardiology (coronarography and coronary angioplasty) in AMI treatment.
Record-linkage between current hospitalisation and mortality databases, aimed to identify total events (hospitalised AMI cases + out-of-hospital coronary deaths), also including recurrent events (rule of 28 days or more after any previous event in the same patient).
Population based registry (residents in Tuscany).
Age-standardised attack rates, 28-day case-fatality and proportion of patients who underwent coronarography or coronary angioplasty.
In Tuscany, between 1997 and 2002, AMI attack rates were stable in both genders. Rates of out-of-hospital coronary death (progressively decreasing) and of hospitalised AMI cases (increasing after the year 2000) showed opposite trends. Case-fatality decreased both for total events (largely explained by the reduction of out-of-hospital deaths) and for hospitalised cases. In the same period, the spread of coronarography and coronary angioplasty progressively increased. AMI attack rates and interventional cardiology procedures utilization were significantly different across Tuscany areas, whereas 28-day case-fatality of hospitalised cases did not significantly differ within the region.
Notwithstanding the importance of cardiovascular disease, scanty population-based incidence, case-fatality and treatment data were available in Italy. Monitoring systems based on current hospitalisation and mortality databases could represent an economical and timely tools, providing data useful in a public health perspective and for health planning. The validation of diagnostic codes with standardised criteria could ensure the comparability with other Italian areas.
托斯卡纳急性心肌梗死区域登记处旨在评估托斯卡纳地区急性心肌梗死（AMI）的发病率和预后，以及介入心脏病学（冠状动脉造影和冠状动脉成形术）在AMI治疗中的普及情况。
将当前住院数据库与死亡率数据库进行记录链接，以确定所有事件（住院的AMI病例+院外冠状动脉死亡病例），还包括复发事件（同一患者在任何先前事件后28天或更长时间的规则）。
基于人群的登记处（托斯卡纳居民）。
年龄标准化发病率、28天病死率以及接受冠状动脉造影或冠状动脉成形术的患者比例。
在托斯卡纳，1997年至2002年间，男女AMI发病率均保持稳定。院外冠状动脉死亡率（逐渐下降）和住院AMI病例数（2000年后增加）呈现相反趋势。总事件的病死率和住院病例的病死率均有所下降。同期，冠状动脉造影和冠状动脉成形术的普及程度逐渐提高。托斯卡纳不同地区的AMI发病率和介入心脏病学手术的使用率存在显著差异，而该地区住院病例的28天病死率并无显著差异。
尽管心血管疾病很重要，但意大利基于人群的发病率、病死率和治疗数据却很少。基于当前住院和死亡率数据库的监测系统可能是一种经济且及时的工具，能提供从公共卫生角度和健康规划方面有用的数据。使用标准化标准对诊断编码进行验证可确保与意大利其他地区具有可比性。
