Mate Redondo Carmen, Rodríguez-Pérez María Cristo, Domínguez Coello Santiago, Pedrero García Arturo J, Marcelino Rodríguez Itahisa, Cuevas Fernández Francisco J, Almeida González Delia, Brito Díaz Buenaventura, Rodríguez Esteban Marcos, Cabrera de León Antonio
Servicio de Medicina Preventiva, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Unidad de Investigación de Atención Primaria, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
Rev Esp Cardiol (Engl Ed). 2019 Jun;72(6):466-472. doi: 10.1016/j.rec.2018.06.023. Epub 2018 Jul 21.
The Canary Islands has the highest mortality from diabetes in Spain. The aim of this study was to determine possible differences in mortality due to acute myocardial infarction (AMI) during hospital admission between this autonomous community and the rest of Spain, as well as the factors associated with this mortality and the population fraction attributable to diabetes.
Cross-sectional study of hospital admissions for AMI in Spain from 2007 to 2014, registered in the Minimum Basic Data Set.
A total of 415 798 AMI were identified. Canary Island patients (16 317) were younger than those living in the rest of Spain (63.93 ± 13.56 vs 68.25 ± 13.94; P < .001) and death occurred 4 years earlier in the archipelago (74.03 ± 11.85 vs 78.38 ± 11.10; P < .001). This autonomous community had the highest prevalence of smoking (44% in men and 23% in women); throughout Spain, AMI occurred 13 years earlier in smokers than in nonsmokers. Patients in the Canary Islands had the highest mortality rates whether they had diabetes (8.7%) or not (7.6%), and they also showed the highest fraction of AMI mortality attributable to diabetes (9.4; 95%CI, 4.8-13.6). After adjustment for type of AMI, diabetes, dyslipidemia, hypertension, smoking, cocaine use, renal failure, sex and age, the Canary Islands showed the highest risk of mortality vs the rest of Spain (OR = 1.25; 95%CI, 1.17-1.33; P < .001) and it was one of the autonomous communities showing no significant improvement in the risk of mortality due to AMI during the study period.
Mortality due to AMI during hospital admission is higher in the Canary Islands than in the rest of Spain.
加那利群岛是西班牙糖尿病死亡率最高的地区。本研究旨在确定该自治区与西班牙其他地区在急性心肌梗死（AMI）住院期间死亡率的可能差异，以及与该死亡率相关的因素和可归因于糖尿病的人群比例。
对2007年至2014年西班牙AMI住院患者进行横断面研究，数据记录于最低基本数据集。
共识别出415798例AMI患者。加那利群岛的患者（16317例）比西班牙其他地区的患者年轻（63.93±13.56岁对68.25±13.94岁；P<.001），该群岛的死亡时间比其他地区早4年（74.03±11.85岁对78.38±11.10岁；P<.001）。该自治区吸烟率最高（男性为44%，女性为23%）；在整个西班牙，吸烟者发生AMI的时间比不吸烟者早13年。无论是否患有糖尿病，加那利群岛的患者死亡率最高（患有糖尿病的患者死亡率为8.7%，未患糖尿病的患者死亡率为7.6%），并且他们的AMI死亡率中可归因于糖尿病的比例也最高（9.4；95%CI，4.8-13.6）。在对AMI类型、糖尿病、血脂异常、高血压、吸烟、可卡因使用、肾衰竭、性别和年龄进行调整后，与西班牙其他地区相比，加那利群岛的死亡风险最高（OR=1.25；95%CI，1.17-1.33；P<.001），并且是在研究期间AMI死亡风险没有显著改善的自治区之一。
加那利群岛AMI住院期间的死亡率高于西班牙其他地区。
