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比较住院时独居与非独居的急性心肌梗死经皮冠状动脉介入治疗患者的长期死亡率。

Comparison of long-term mortality after acute myocardial infarction treated by percutaneous coronary intervention in patients living alone versus not living alone at the time of hospitalization.

机构信息

Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Am J Cardiol. 2014 Aug 15;114(4):522-7. doi: 10.1016/j.amjcard.2014.05.029. Epub 2014 Jun 6.

Abstract

Living alone was reported to be associated with increased risk of cardiovascular disease. There are, however, limited data on the relation between living alone and all-cause mortality in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The Coronary REvascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) AMI registry was a cohort study of patients with AMI enrolled in 26 hospitals in Japan from 2005 through 2007. For the current analysis, we included those patients who underwent PCI within 24 hours of symptom onset, and we assessed their living status to determine if living alone would be an independent prognostic risk factor. Among 4,109 patients eligible for the current analysis of 5,429 patients enrolled in the CREDO-Kyoto AMI registry, 515 patients (12.5%) were living alone at the time of hospital admission. The cumulative 5-year incidence of all-cause death was 18.3% in the living alone group and 20.1% in the not living alone group (log-rank p = 0.77). After adjusting for potential confounders, risk of the living alone group relative to the not living alone group for all-cause death was not significantly different (adjusted hazard ratio 0.82, 95% confidence interval 0.65 to 1.02, p = 0.08). In a subgroup analysis stratified by age, the adjusted risk for all-cause death was also not different between the living alone group and the not living alone group both in the older population (aged ≥75 years) and the younger population (aged <75 years). In conclusion, living alone was not associated with higher long-term mortality in patients with AMI who underwent PCI.

摘要

独居与心血管疾病风险增加有关。然而,关于独居与经皮冠状动脉介入治疗(PCI)后急性心肌梗死(AMI)患者全因死亡率之间的关系,数据有限。冠心病再血管化治疗结果研究(CREDO-Kyoto)AMI 注册研究是一项队列研究,纳入了 2005 年至 2007 年日本 26 家医院的 AMI 患者。目前的分析纳入了在症状发作后 24 小时内接受 PCI 的患者,并评估了他们的生活状况,以确定独居是否是独立的预后危险因素。在当前纳入的 5429 名 CREDO-Kyoto AMI 注册患者中的 4109 名患者中,515 名(12.5%)在入院时独居。独居组的 5 年全因死亡率累积发生率为 18.3%,非独居组为 20.1%(对数秩检验,p=0.77)。在校正潜在混杂因素后,独居组与非独居组相比,全因死亡的风险比(adjusted hazard ratio,aHR)并不显著不同(调整后的 HR 为 0.82,95%置信区间为 0.65 至 1.02,p=0.08)。在按年龄分层的亚组分析中,独居组和非独居组的全因死亡调整风险在年龄较大(≥75 岁)和年龄较小(<75 岁)的人群中也没有差异。总之,独居与接受 PCI 的 AMI 患者的长期死亡率升高无关。

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