Department of Medicine, Columbia University Medical Center, Presbyterian Hospital, New York, NY 10032, USA.
Heart. 2012 Nov;98(22):1660-6. doi: 10.1136/heartjnl-2012-302318. Epub 2012 Sep 2.
Self-report of physician diagnosis and ECG 'Q' waves are common survey measures of prior myocardial infarction (MI) prevalence. We sought to assess relative prevalence of self-reported prior MI and ECG Q-waves (ECG-MI) in populations and population subgroups with varying MI prevalence.
A secondary analysis of seven population-based cross-sectional surveys of prevalent MI selected from a systematic review of ischaemic heart disease epidemiology.
Men and women aged 45-74 years in population-based Belgian surveys (1978--1998, n=29 419) and US National Health and Nutrition Examination Surveys (1976-1994, n=11 107). Comparison of the US and Belgian surveys with surveys in seven other nations (United Kingdom, Russia, Lithuania, Belarus, India, Turkey and Ghana).
Prevalence of prior MI measured by self-report or resting ECG Q-waves (ECG-MI; Minnesota ECG codes 1.1 and 1.2).
Self-reported prior MI prevalence was 1.5-2.6 times higher than ECG-MI in Belgian and US men aged 45-74 years and women 55-74 years. ECG-MI was more prevalent than self-reported MI in women <55 years old, and self-reported MI relatively low in US African-American men compared with US Caucasian men. In the overall nine-nation comparison, there was no consistent relationship between self-reported MI and ECG-MI. ECG-MI was higher relative to self-report in nations with lower prevalence of ischaemic heart disease.
Self-reported MI and ECG-MI prevalence may only be reliable in higher ischaemic heart disease incidence groups. Self-report and ECG-MI have limited accuracy, and ECG Q-waves likely capture fewer prior MIs in the 21st century. The limitations of current survey prevalence measures of MI should be taken into account when measuring the burden of ischaemic heart disease in populations.
医生诊断和心电图“Q”波的自我报告是常见的心肌梗死（MI）患病率调查指标。我们旨在评估具有不同 MI 患病率的人群和人群亚组中自我报告的既往 MI 和心电图 Q 波（ECG-MI）的相对患病率。
从缺血性心脏病流行病学系统评价中选择的七个基于人群的 MI 现患横断面调查的二次分析。
比利时基于人群的调查（1978-1998 年，n=29419）和美国国家健康和营养检查调查（1976-1994 年，n=11107）中 45-74 岁的男性和女性。将美国和比利时的调查与其他七个国家（英国、俄罗斯、立陶宛、白俄罗斯、印度、土耳其和加纳）的调查进行比较。
通过自我报告或静息心电图 Q 波（ECG-MI；明尼苏达州心电图代码 1.1 和 1.2）测量的既往 MI 的患病率。
在 45-74 岁的比利时和美国男性以及 55-74 岁的女性中，自我报告的既往 MI 患病率是心电图-MI 的 1.5-2.6 倍。在年龄<55 岁的女性中，ECG-MI 的患病率高于自我报告的 MI，而在美国非裔男性中，自我报告的 MI 相对较低，与美国白人男性相比。在整个九个国家的比较中，自我报告的 MI 与 ECG-MI 之间没有一致的关系。在缺血性心脏病发病率较低的国家，ECG-MI 相对于自我报告更高。
自我报告的 MI 和 ECG-MI 患病率可能仅在缺血性心脏病发病率较高的人群中可靠。自我报告和 ECG-MI 的准确性有限，并且在 21 世纪，心电图 Q 波可能会捕获较少的既往 MI。在衡量人群中缺血性心脏病负担时，应考虑当前 MI 患病率调查测量的局限性。
