McGovern P G, Folsom A R, Sprafka J M, Burke G L, Doliszny K M, Demirovic J, Naylor J D, Blackburn H
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.
Circulation. 1992 Jan;85(1):172-9. doi: 10.1161/01.cir.85.1.172.
The Minnesota Heart Survey is a population-based study designed to monitor and explain trends in cardiovascular mortality, morbidity, and risk factors. As part of this effort, a 50% sample of patients hospitalized for myocardial infarction (MI) in the seven-county Twin Cities (Minneapolis and St. Paul) metropolitan area was reviewed in 1970, 1980, and 1985. Those with a validated definite MI were followed for 4-year mortality. The purpose was to determine whether the improved survival observed between 1970 and 1980 was extended to the 1980-1985 period.
Crude 28-day mortality in men changed from 18% in 1970 to 12% in 1980 to 13% in 1985; in women it changed from 27% in 1970 to 22% in 1980 to 18% in 1985. After adjustment for severity factors (e.g., age, previous MI, and admission heart rate and systolic blood pressure), 28-day mortality was significantly lower in 1980 than in 1970 in men (RR, 0.66; 95% CI, 0.47, 0.92) and in women (RR, 0.69; 95% CI, 0.46, 1.04), but no change occurred from from 1980 to 1985 (p greater than 0.25). After adjustment for severity indicators, 4-year survival was better in 1980 than in 1970 for men (RR, 0.67; 95% CI, 0.54, 0.83) and for women (RR, 0.72; 95% CI, 0.54, 0.98), but there was no significant change from 1980 to 1985 (p greater than 0.25).
These results suggest that improvements in survival among hospitalized MI patients contributed to the overall decline in coronary heart disease mortality in the Twin Cities area between 1970 and 1980 but not between 1980 and 1985.
明尼苏达心脏调查是一项基于人群的研究，旨在监测和解释心血管疾病死亡率、发病率及危险因素的趋势。作为此项工作的一部分，1970年、1980年和1985年对明尼阿波利斯和圣保罗双城七县都会区因心肌梗死（MI）住院的患者进行了50%的抽样审查。对确诊为MI的患者进行了4年死亡率随访。目的是确定1970年至1980年观察到的生存率提高是否延续到1980年至1985年期间。
男性患者的28天粗死亡率从1970年的18%降至1980年的12%，再降至1985年的13%；女性患者的28天粗死亡率从1970年的27%降至1980年的22%，再降至1985年的18%。在对严重程度因素（如年龄、既往心肌梗死、入院时心率和收缩压）进行调整后，1980年男性患者的28天死亡率显著低于1970年（RR，0.66；95%CI，0.47，0.92），女性患者也是如此（RR，0.69；95%CI，0.46，1.04），但1980年至1985年没有变化（p>0.25）。在对严重程度指标进行调整后，1980年男性患者的4年生存率高于1970年（RR，0.67；95%CI，0.54，0.83），女性患者也是如此（RR，0.72；95%CI，0.54，0.98），但1980年至1985年没有显著变化（p>0.25）。
这些结果表明，住院心肌梗死患者生存率的提高有助于1970年至1980年双城地区冠心病死亡率的总体下降，但1980年至1985年期间并非如此。
