Saner Hugo, Mollet Jannette D, Berlin Claudia, Windecker Stephan, Meier Bernhard, Räber Lorenz, Zwahlen Marcel, Stute Petra
Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern, Inselspital Bern, Switzerland.
Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern, Inselspital Bern, Switzerland.
Int J Cardiol. 2017 Sep 15;243:59-64. doi: 10.1016/j.ijcard.2017.05.045. Epub 2017 May 13.
Morbidity and mortality from cardiovascular diseases have decreased since the 1970s in most Western societies. However, it is unclear if this positive trend can also be found in younger women suffering from acute coronary syndrome (ACS).
This is a prospective single center registry study including 11.015 women and men hospitalized for a first ACS between the years 2001 and 2010. We analyzed ACS rates according to sex and age group using Poisson regression in order to assess temporal trends.
Overall ACS hospitalization rates per 100.000 inhabitants increased by 31% between 2001 and 2010 (Rate Ratio (RR) of 1.31, 95% CI 1.20-1.43; p<0.001) with a similar increase in men (RR 1.29, p<0.00001) and women (RR 1.35, p<0.0001). Analyses of age-specific ACS rates showed a significant increase in ACS hospitalization rates only for the age groups 70-79years (p=0.003) and 80+ years (p<0.00001). None of the age matched subgroups showed a sex related significant difference in trend for ACS hospitalization rates. Temporal trends for recorded risk factors showed a significant increase in smoking (p=0.03), and a trend to increased obesity prevalence (p=0.06) in females in the age group 60-69years.
In contrast to other studies, we found no evidence for a particular increase in the number of younger women referred for a first ACS during the years 2001 and 2010. Potential negative effects of smoking and obesity on ACS incidence may be delayed to women older than 70years.
自20世纪70年代以来，大多数西方社会中心血管疾病的发病率和死亡率有所下降。然而，目前尚不清楚这种积极趋势是否也存在于患有急性冠状动脉综合征（ACS）的年轻女性中。
这是一项前瞻性单中心登记研究，纳入了2001年至2010年间因首次急性冠状动脉综合征住院的11015名女性和男性。我们使用泊松回归分析按性别和年龄组划分的急性冠状动脉综合征发病率，以评估时间趋势。
2001年至2010年间，每10万居民中急性冠状动脉综合征的总体住院率增加了31%（率比（RR）为1.31，95%置信区间1.20 - 1.43；p < 0.001），男性（RR 1.29，p < 0.00001）和女性（RR 1.35，p < 0.0001）的增加情况相似。对特定年龄的急性冠状动脉综合征发病率分析显示，仅70 - 79岁年龄组（p = 0.003）和80岁及以上年龄组（p < 0.00001）的急性冠状动脉综合征住院率有显著增加。在年龄匹配的亚组中，急性冠状动脉综合征住院率的趋势均未显示出与性别相关的显著差异。记录的危险因素的时间趋势显示，60 - 69岁年龄组女性吸烟率显著增加（p = 0.03），肥胖患病率有增加趋势（p = 0.06）。
与其他研究不同，我们发现在2001年至2010年间，没有证据表明首次因急性冠状动脉综合征就诊的年轻女性数量有特别增加。吸烟和肥胖对急性冠状动脉综合征发病率的潜在负面影响可能在70岁以上女性中才会显现。
