Section of Cardiology, Department of Medicine, The Southern Arizona VA Health Care System, Tucson, Arizona 85721, USA.
Clin Cardiol. 2011 Nov;34(11):689-92. doi: 10.1002/clc.20968.
Non-ST-segment myocardial infarction (NSTEMI) is one of the major causes of hospital admissions. Mortality trend in patients with NSTEMI over the years has not been studied well. The goal of this study is to explore age-adjusted long-term mortality trends from NSTEMI in the United States using a very large database.
We used the National Inpatient Sample (NIS) database, a component of the Health Care Cost and Utilization (HCUP) project, for this study. International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify NSTEMI cases in patients >40 years old. Age-adjusted mortality rates for NSTEMI cases were calculated by multiplying the age-specific mortality rates of NSTEMI by age-specific weights.
A total of 1,400,234 patients above the age of 40 years were identified. The mean age of this cohort was 77.1±10.7 years, with a total of 179,361 deaths being reported over this 16-year period. Among patients who died, 51.2% were men and 48.8% were women. The age-adjusted mortality from NSTEMI declined from 1988 (727 per 100,000) to 2004 (305 per 100,000) until the middle of the decade when mortality from NSTEMI started leveling off. Total mortality decreased from 29.6% in 1988 to 11.3% in 2004.
Our analysis showed a significant reduction in the age-adjusted and total mortality for NSTEMI over the years studied. The cause of this trend is not known but most likely reflects advancement in the treatment of patients with acute coronary syndrome.
非 ST 段抬高型心肌梗死（NSTEMI）是住院的主要原因之一。近年来，NSTEMI 患者的死亡率趋势尚未得到很好的研究。本研究的目的是使用一个非常大的数据库探讨美国 NSTEMI 患者的年龄调整后长期死亡率趋势。
我们使用了国家住院患者样本（NIS）数据库，这是医疗保健成本和利用（HCUP）项目的一个组成部分。使用国际疾病分类，第九修订版，临床修正（ICD-9-CM）代码来识别>40 岁的患者中的 NSTEMI 病例。通过将 NSTEMI 病例的年龄特异性死亡率乘以年龄特异性权重来计算 NSTEMI 病例的年龄调整死亡率。
共确定了 1400234 名>40 岁的患者。该队列的平均年龄为 77.1±10.7 岁，在这 16 年期间共报告了 179361 例死亡。在死亡患者中，51.2%为男性，48.8%为女性。NSTEMI 的年龄调整死亡率从 1988 年（每 100000 人 727 人）下降到 2004 年（每 100000 人 305 人），直到十年中旬 NSTEMI 的死亡率开始趋于平稳。总死亡率从 1988 年的 29.6%下降到 2004 年的 11.3%。
我们的分析表明，在研究的几年中，NSTEMI 的年龄调整和总死亡率显著降低。这种趋势的原因尚不清楚，但很可能反映了急性冠状动脉综合征患者治疗的进步。
