Balda-Canizares Javier A, Tamariz Leonardo, Moreno-Zambrano Daniel, Pareja Denisse, Ortiz-Prado Esteban, Palacio Alfredo, Palacio Ana
Facultad de Ciencias Medicas, Universidad Catolica Santiago de Guayaquil, Guayaquil, Ecuador.
Division of Population Health and Computational Medicine, University of Miami, Miami, USA.
Cardiovasc Diagn Ther. 2018 Aug;8(4):493-499. doi: 10.21037/cdt.2018.07.03.
Developed countries continue to show a decrease in cardiovascular disease (CVD) mortality. Little is known about CVD mortality trends in low and middle-income countries. The aim of our study is to describe myocardial infarction (MI) mortality trends and evaluate if differences between ethnic groups and geographic regions are present among the Ecuadorians with acute MI.
We conducted a cross sectional analysis mortality national registry and included deaths related to MI between 2012 and 2016 that had complete demographic data. To describe the general population, we used the 2010 census and applied estimates as population projections. We calculated age and sex standardized MI mortality rates per 100,000. We compared trends in MI mortality rate for every ethnic group and geographic region and used linear regression to estimate predictors of the changing mortality rates.
We included 18,277 MI deaths between the years 2012 and 2016. The mean age of death was 73.6±19.5, 59% were male and 33% were illiterate. From 2012 to 2016, the standardized MI mortality rate increased from 51 to 157 deaths per 100,000. The most significant predictors of the increasing mortality rate were living in the coast (β=0.10), belonging to a mixed race (β=-0.033) and the year of death (β=0.013).
Our study found a worrisome increase in MI mortality between 2012-2016 in Ecuador, a middle-income country in South America. This rapid increase seems to be driven by geographic and racial differences. A thorough evaluation of the causes of this increase has to be undertaken by the Ecuadorian health authorities.
发达国家心血管疾病（CVD）死亡率持续下降。关于低收入和中等收入国家的CVD死亡率趋势，人们了解甚少。我们研究的目的是描述心肌梗死（MI）死亡率趋势，并评估急性心肌梗死的厄瓜多尔人在种族群体和地理区域之间是否存在差异。
我们对全国死亡率登记处进行了横断面分析，纳入了2012年至2016年期间有完整人口统计学数据的与心肌梗死相关的死亡病例。为描述总体人群，我们使用了2010年人口普查数据并应用估计值作为人口预测。我们计算了每10万人中年龄和性别标准化的心肌梗死死亡率。我们比较了每个种族群体和地理区域的心肌梗死死亡率趋势，并使用线性回归来估计死亡率变化的预测因素。
我们纳入了2012年至2016年期间的18277例心肌梗死死亡病例。平均死亡年龄为73.6±19.5岁，59%为男性，33%为文盲。从2012年到2016年，标准化心肌梗死死亡率从每10万人51例死亡增加到157例。死亡率上升的最显著预测因素是居住在沿海地区（β=0.10）、属于混血种族（β=-0.033）和死亡年份（β=0.013）。
我们的研究发现，在南美洲的中等收入国家厄瓜多尔，2012 - 2016年间心肌梗死死亡率出现了令人担忧的上升。这种快速上升似乎是由地理和种族差异驱动的。厄瓜多尔卫生当局必须对这种上升的原因进行全面评估。
