Blanc J J, Ropars G, Boschat J, Etienne Y, Penther P
Arch Mal Coeur Vaiss. 1986 Feb;79(2):143-51.
The aim of this study was to compare two groups of patients admitted consecutively to the Coronary Care Unit in 1972-73 (223 cases) and in 1982-83 (243 cases) for recent myocardial infarction, and followed up for at least 15 days, to try and appreciate the influence of changes in treatment which had taken place during this interval on outcome and mortality. The two groups were comparable with regards to age, sex, time of admission with respect to onset of symptoms, previous vascular disease, and principal coronary risk factors. The clinical presentation of myocardial infarction and its common complications (cardiac failure, arrhythmias) were unchanged at 10 years' interval. The only statistically significant but unexplained difference was the lower proportion of posterior infarctions in 1982-1983 compared to 1972-1973. This decrease was partly due to the increased detection of rudimentary infarcts by more specific enzyme methods. The decrease in the proportion of posterior infarcts probably also explained the lower numbers of atrioventricular blocks. Other differences between the two groups were not statistically significant (slight increase in age, fewer women, lower incidence of cardiac failure). The mortality rate was exactly the same at 20.6%, and the causes of death were identical. The results support those of other rare studies of the same subject showing the lack of effect of recent therapeutic innovations on the majority of patients with myocardial infarction.
本研究旨在比较1972 - 1973年(223例)和1982 - 1983年(243例)连续入住冠心病监护病房的两组近期心肌梗死患者,并对其进行至少15天的随访,以试图了解在此期间治疗方法的变化对预后和死亡率的影响。两组在年龄、性别、症状发作后的入院时间、既往血管疾病以及主要冠状动脉危险因素方面具有可比性。心肌梗死的临床表现及其常见并发症(心力衰竭、心律失常)在10年期间没有变化。唯一具有统计学意义但无法解释的差异是,与1972 - 1973年相比,1982 - 1983年后壁梗死的比例较低。这种下降部分归因于更特异的酶法对微小梗死的检测增加。后壁梗死比例的下降可能也解释了房室传导阻滞数量的减少。两组之间的其他差异无统计学意义(年龄略有增加、女性较少、心力衰竭发生率较低)。死亡率完全相同,均为20.6%,死亡原因也相同。这些结果支持了同一主题的其他少数研究的结果,表明近期治疗创新对大多数心肌梗死患者没有影响。