[2007 - 2012年北京急性心肌梗死住院患者30天病死率的变化趋势]
[Trends in 30-day case fatality rate in patients hospitalized due to acute myocardial infarction in Beijing, 2007-2012].
作者信息
Sun J Y, Zhang Q, Zhao D, Wang M, Gao S, Han X Y, Liu J
机构信息
Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
出版信息
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Mar 10;39(3):363-367. doi: 10.3760/cma.j.issn.0254-6450.2018.03.022.
To understand the distribution and trends in 30-day coronary heart disease (CHD) case fatality rate in patients hospitalized due to acute myocardial infarction (AMI) in Beijing during 2007-2012. The clinical data of patients hospitalized due to AMI in Beijing from 1 January 2007 to 31 December 2012 were collected from "The Cardiovascular Disease Surveillance System in Beijing" . A total of 77 943 local patients aged ≥25 years were hospitalized due to AMI in Beijing during the this period. After excluding duplicate records and validation for the completeness and accuracy of the records, the clinical characteristics of the patients and 30-day CHD case fatality rate in the patients were analyzed. Trends in 30-day CHD case fatality rate in the patients were analyzed with Poisson regression models. The age-standardized average 30-day CHD case fatality rate was 9.7% in the 77 943 patients. During this period, a decreasing trend was observed in 30-day CHD case fatality rate after adjusting for age and gender (<0.001). The age-standardized 30-day CHD case fatality rate decreased by 16.0%, from 10.8% in 2007 to 9.0% in 2012. The decreases of 30-day CHD case fatality rates were noted in both men and women, whereas 30-day CHD case fatality rate was higher in women (14.1%) than in men (7.6%) after adjusting for age. During this period, the proportion of ST-segment elevation myocardial infarction (STEMI) decreased, while the proportion of non-ST-segment elevation myocardial infarction (NSTEMI) increased with year. A significant decline (20.1%) in 30-day case fatality rate of STEMI was found, but no decline was found for 30-day mortality rate of NSTEMI. A decreasing trend in 30-day CHD case fatality rate was observed in the patients aged ≥25 years and hospitalized due to AMI in Beijing during 2007-2012, indicating the improvement in short-term prognosis of patients hospitalized due to AMI. Our findings highlight the urgent need to improve the treatment for woman and NSTEMI patients.
了解2007 - 2012年期间北京因急性心肌梗死（AMI）住院患者30天冠心病（CHD）病死率的分布及变化趋势。从“北京心血管疾病监测系统”收集2007年1月1日至2012年12月31日期间北京因AMI住院患者的临床资料。在此期间，北京共有77943例年龄≥25岁的本地患者因AMI住院。在排除重复记录并验证记录的完整性和准确性后，分析了患者的临床特征及患者的30天冠心病病死率。采用泊松回归模型分析患者30天冠心病病死率的变化趋势。77943例患者的年龄标准化平均30天冠心病病死率为9.7%。在此期间，调整年龄和性别后，30天冠心病病死率呈下降趋势（<0.001）。年龄标准化的30天冠心病病死率下降了16.0%，从2007年的10.8%降至2012年的9.0%。男性和女性的30天冠心病病死率均有所下降，然而调整年龄后女性的30天冠心病病死率（14.1%）高于男性（7.6%）。在此期间，ST段抬高型心肌梗死（STEMI）的比例下降，而非ST段抬高型心肌梗死（NSTEMI）的比例随年份增加。STEMI的30天病死率显著下降（20.1%），但NSTEMI的30天死亡率未下降。2007 - 2012年期间，北京年龄≥25岁因AMI住院患者的30天冠心病病死率呈下降趋势，表明因AMI住院患者的短期预后有所改善。我们的研究结果凸显了改善女性和NSTEMI患者治疗的迫切需求。
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