特立尼达和多巴哥首次急性心肌梗死患者的危险因素。
Risk factors for first-time acute myocardial infarction patients in Trinidad.
机构信息
School of Medicine, Faculty of Medical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad, Trinidad and Tobago.
, Trinidad, Trinidad and Tobago.
出版信息
BMC Public Health. 2018 Jan 19;18(1):161. doi: 10.1186/s12889-018-5080-y.
BACKGROUND
The relative importance of coronary artery disease (CAD) risk varies globally. The aim of this study was to determine CAD risk factors for acute myocardial infarction (AMI) among patients in public health care institutions in Trinidad using a case-control type study design.
METHODS
The sample comprised 251 AMI patients hospitalized between March 1, 2011 and April 30, 2012 and 464 age- and sex-matched non-AMI patients with no terminal or life-threatening illness and who did not undergo treatment for CAD. SPSS version 19 was used for data analysis that included chi-square tests, unadjusted and adjusted odds ratios (OR) and conditional multiple binary logistic regression.
RESULTS
There was no difference in age between AMI and non-AMI patients (p = 0.551). Chi-square test revealed that clinical and lifestyle variables including stressful life, diabetes, hypertension, hypercholesterolaemia, ischaemic heart disease (IHD), a family history of IHD (p ≤ 0.001), smoking (p = 0.007) and alcohol consumption (p = 0.013) were associated with AMI; sex (p = 0.441), ethnicity (p = 0.366), age group (p = 0.826) and renal failure (p = 0.487) were not. Both unadjusted and adjusted (for age) ORs showed that the odds of hypertension, IHD and alcohol consumption were greater among AMI patients than among non-AMI patients for males; diabetes and IHD for females; and that the odds of a stressful life was greater among non-AMI patients and were the same for both groups with respect to sex, age > 45 years, hypercholesterolemia, renal insufficiency, and family history of IHD. Conditional multiple logistic regression showed that smoking [OR: 0.274, p ≤ 0.001, 95% CI for OR (0.140, 0.537)], a stressful life [OR: 2.697, p ≤ 0.001, 95% CI for OR (1.585, 4.587)], diabetes [OR: 0.530, p = 0.020, 95% CI for OR (0.310, 0.905)], hypertension [OR: 0.48, p = 0.10. 95% CI for OR (0.275, 0.837)] and IHD [OR: 0.111, p ≤ 0.001, 95% CI for OR (0.057, 0.218)] were the only useful AMI predictors.
CONCLUSIONS
Smoking, diabetes, hypertension, IHD and decrease stress are useful AMI predictors.
背景
冠心病（CAD）的相对重要性在全球范围内有所不同。本研究的目的是使用病例对照研究设计，确定特立尼达公共医疗机构中急性心肌梗死（AMI）患者的 CAD 危险因素。
方法
该样本包括 2011 年 3 月 1 日至 2012 年 4 月 30 日期间住院的 251 名 AMI 患者和 464 名年龄和性别匹配的非 AMI 患者，这些患者没有终末期或危及生命的疾病，也没有接受 CAD 治疗。使用 SPSS 版本 19 进行数据分析，包括卡方检验、未调整和调整后的比值比（OR）和条件多元二项逻辑回归。
结果
AMI 和非 AMI 患者的年龄无差异（p=0.551）。卡方检验显示，临床和生活方式变量，包括压力生活、糖尿病、高血压、高胆固醇血症、缺血性心脏病（IHD）、IHD 家族史（p≤0.001）、吸烟（p=0.007）和饮酒（p=0.013）与 AMI 相关；性别（p=0.441）、种族（p=0.366）、年龄组（p=0.826）和肾功能衰竭（p=0.487）与 AMI 无关。未调整和调整（年龄）的 OR 均显示，与非 AMI 患者相比，男性中高血压、IHD 和饮酒的 AMI 患者的患病几率更高；女性中糖尿病和 IHD；对于压力生活，非 AMI 患者的患病几率更高，两组在性别、年龄>45 岁、高胆固醇血症、肾功能不全和 IHD 家族史方面的患病几率相同。条件多元逻辑回归显示，吸烟[OR：0.274，p≤0.001，OR（0.140，0.537）的 95%CI]、压力生活[OR：2.697，p≤0.001，OR（1.585，4.587）的 95%CI]、糖尿病[OR：0.530，p=0.020，OR（0.310，0.905）的 95%CI]、高血压[OR：0.48，p=0.10，OR（0.275，0.837）的 95%CI]和 IHD[OR：0.111，p≤0.001，OR（0.057，0.218）的 95%CI]是唯一有用的 AMI 预测因子。
结论
吸烟、糖尿病、高血压、IHD 和减轻压力是有用的 AMI 预测因子。
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