Grey Corina, Jackson Rod, Wells Susan, Wu Billy, Poppe Katrina, White Harvey, Chan Wing Cheuk, Kerr Andrew J
Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.
Greenlane Cardiovascular Services, Auckland City Hospital, Auckland, New Zealand.
Heart. 2018 Jan;104(1):51-57. doi: 10.1136/heartjnl-2017-311613. Epub 2017 Jun 29.
To examine recent trends in first and recurrent ischaemic heart disease (IHD) deaths and hospitalisations.
Using anonymous patient-linkage of routinely collected data, all New Zealanders aged 35-84 years who experienced an International Statistical Classification of Diseases and Related Health Problems I(CD)-coded IHD hospitalisation and/or IHD death between 1 January 2005 and 31 December 2015 were identified. A 10-year look-back period was used to differentiate those experiencing first from recurrent events. Age-standardised hospitalisation and mortality rates were calculated for each calendar year and trends compared by sex and age.
160 109 people experienced at least one IHD event (259 678 hospitalisations and 35 548 deaths) over the 11-year study period, and there was a steady decline in numbers (from almost 24 000 in 2005 to just over 16 000 in 2015) and in age-standardised rates each year. With the exception of deaths in younger (35-64 years) women with prior IHD, there was a significant decline in IHD events in men and women of all ages, with and without a history of IHD. The decline in IHD mortality was greater for those experiencing a first rather than recurrent IHD event (3.8%-5.2% vs 0%-3.7% annually on average). In contrast, the decline in IHD hospitalisations was greater for those experiencing a recurrent compared with a first IHD event (5.6%-7.3% vs 3.2%-5.7% annually on average).
The substantial decline in IHD hospitalisations and mortality observed in New Zealanders with and without prior IHD between 2005 and 2015 suggests that primary and secondary prevention efforts have been effective in reducing the occurrence of IHD events.
研究首次及复发性缺血性心脏病（IHD）死亡和住院的近期趋势。
利用常规收集数据的匿名患者关联，确定了2005年1月1日至2015年12月31日期间所有年龄在35 - 84岁、经历过国际疾病和相关健康问题统计分类（ICD）编码的IHD住院和/或IHD死亡的新西兰人。采用10年回顾期来区分首次事件和复发性事件。计算每个日历年的年龄标准化住院率和死亡率，并按性别和年龄比较趋势。
在11年的研究期内，160109人经历了至少一次IHD事件（259678次住院和35548例死亡），每年的事件数量（从2005年的近24000例降至2015年的略超过16000例）和年龄标准化率均呈稳步下降。除了既往有IHD的年轻（35 - 64岁）女性的死亡外，所有年龄、有或无IHD病史的男性和女性的IHD事件均显著下降。首次发生IHD事件者的IHD死亡率下降幅度大于复发性IHD事件者（平均每年分别为3.8% - 5.2%和0% - 3.7%）。相比之下，复发性IHD事件者的IHD住院率下降幅度大于首次发生IHD事件者（平均每年分别为5.6% - 7.3%和3.2% - 5.7%）。
2005年至2015年期间，有或无既往IHD的新西兰人IHD住院率和死亡率大幅下降，这表明一级和二级预防措施在减少IHD事件的发生方面是有效的。
