Heart and Vascular Institute, Cleveland Clinic, OH, United States.
Heart and Vascular Institute, Cleveland Clinic, OH, United States.
Int J Cardiol. 2017 Dec 1;248:69-72. doi: 10.1016/j.ijcard.2017.05.011. Epub 2017 Jul 8.
Coronary artery disease (CAD) is the leading cause of mortality around the world. We sought to study changes in the risk profile of patients presenting with ST elevation myocardial infarction (STEMI).
We retrospectively studied all patients presenting with STEMI to our center between 1995 and 2014. Patients were divided into four quartiles, 5years each. Baseline risk factors and comorbidities were recorded. Sub-analysis was done for patients with established CAD and their household incomes.
A total of 3913 patients (67.9% males) were included; 42.5% presented with anterior STEMI and 57.5% inferior STEMI. Ages were 64±12, 62±13, 61±13 and 60±13 in the four quartiles respectively. Obesity prevalence was 31, 37, 38 and 40% and diabetes mellitus prevalence was 24, 25, 24 and 31%, while hypertension was 55, 67, 70 and 77%, respectively, p<0.01 for all. Smoking prevalence was 28, 32, 42 and 46, p<0.01. When subgroup analysis was done for patients with history of CAD, prevalence of smoking, obesity, diabetes and hypertension significantly increased across the four quartiles. When patients were divided to four groups based on household income (poor, low middle, middle and high income), prevalence of diabetes, hypertension, smoking and obesity were significantly higher in patients with low income.
Despite better understanding of cardiovascular risk factors and more focus on preventive cardiology, patients presenting with STEMI over the past 20years are getting younger and more obese, with more prevalence of smoking, hypertension, and diabetes mellitus. This trend is greater in the lower income population.
冠心病（CAD）是全球范围内导致死亡的主要原因。我们试图研究ST 段抬高型心肌梗死（STEMI）患者的风险状况变化。
我们回顾性研究了 1995 年至 2014 年期间在我们中心就诊的所有 STEMI 患者。患者被分为四个四分位数，每个四分位数为 5 年。记录了基线风险因素和合并症。对已确诊 CAD 的患者及其家庭收入进行了亚组分析。
共纳入 3913 例患者（67.9%为男性）；42.5%为前壁 STEMI，57.5%为下壁 STEMI。四个四分位数的年龄分别为 64±12、62±13、61±13 和 60±13。肥胖患病率分别为 31%、37%、38%和 40%，糖尿病患病率分别为 24%、25%、24%和 31%，而高血压患病率分别为 55%、67%、70%和 77%，p<0.01）。吸烟率分别为 28%、32%、42%和 46%，p<0.01。对有 CAD 病史的患者进行亚组分析时，四个四分位数的吸烟、肥胖、糖尿病和高血压的患病率显著增加。当根据家庭收入（贫困、中下、中等和高收入）将患者分为四组时，低收入组的糖尿病、高血压、吸烟和肥胖患病率显著较高。
尽管对心血管风险因素的认识有所提高，并且更加关注预防心脏病学，但在过去 20 年中，患有 STEMI 的患者年龄越来越小，越来越肥胖，吸烟、高血压和糖尿病的患病率也越来越高。这种趋势在低收入人群中更为明显。
