Yawn Barbara P, Wollan Peter C, Yawn Roy A, Jacobsen Steven J, Roger Veronique
Department of Research, Olmsted Medical Center, Rochester, MN, USA.
BMC Fam Pract. 2007 Apr 4;8:18. doi: 10.1186/1471-2296-8-18.
CHD is a chronic disease often present years prior to incident AMI. Earlier recognition of CHD may be associated with higher levels of recognition and treatment of CHD risk factors that may delay incident AMI. To assess timing of CHD and CHD risk factor diagnoses prior to incident AMI.
This is a 10-year population based medical record review study that included all medical care providers in Olmsted County, Minnesota for all women and a sample of men residing in Olmsted County, MN with confirmed incident AMI between 1995 and 2000.
All medical care for the 10 years prior to incident AMI was reviewed for 150 women and 148 men (38% sample) in Olmsted County, MN. On average, women were older than men at the time of incident AMI (74.7 versus 65.9 years, p < 0.0001). 30.4% of the men and 52.0% of the women received diagnoses of CHD prior to incident AMI (p = 0.0002). Unrecognized and untreated CHD risk factors were present in both men (45% of men 5 years prior to AMI) and women (22% of women 5 years prior to first AMI), more common in men and those without a diagnosis of CHD prior to incident AMI (p < 0.0001).
A CHD diagnosis prior to incident AMI is associated with higher rates of recognition and treatment of CHD risk factors suggesting that diagnosing CHD prior to AMI enhances opportunities to lower the risk of future CHD events.
冠心病是一种慢性疾病，常在急性心肌梗死发生前数年就已存在。更早识别冠心病可能与对冠心病危险因素更高水平的识别和治疗相关，这可能会延迟急性心肌梗死的发生。目的是评估急性心肌梗死发生前冠心病及冠心病危险因素的诊断时间。
这是一项基于10年人口的病历回顾研究，纳入了明尼苏达州奥尔姆斯特德县的所有医疗服务提供者，包括所有女性以及居住在明尼苏达州奥尔姆斯特德县、在1995年至2000年间确诊急性心肌梗死的男性样本。
对明尼苏达州奥尔姆斯特德县150名女性和148名男性（38%的样本）急性心肌梗死发生前10年的所有医疗记录进行了回顾。急性心肌梗死发生时，女性平均年龄大于男性（74.7岁对65.9岁，p<0.0001）。30.4%的男性和52.0%的女性在急性心肌梗死发生前被诊断为冠心病（p = 0.（此处原文有误，应为0.0002））。男性（急性心肌梗死发生前5年，45%的男性）和女性（首次急性心肌梗死发生前5年，22%的女性）均存在未被识别和未治疗的冠心病危险因素，在男性以及急性心肌梗死发生前未被诊断为冠心病的人群中更为常见（p<0.0001）。
急性心肌梗死发生前的冠心病诊断与冠心病危险因素更高的识别和治疗率相关，这表明在急性心肌梗死发生前诊断冠心病可增加降低未来冠心病事件风险的机会。
