Schulte H, Assmann G
Institut für Arterioskleroseforschung, Universität Münster.
Soz Praventivmed. 1988;33(1):32-6. doi: 10.1007/BF02084003.
In the 'Prospective Cardiovascular Münster' (PROCAM) study since 1979 employees have been examined for cardiovascular risk factors and held under observation for the onset of clinically significant signs of atherosclerosis (myocardial infarction, stroke, coronary death). Until the end of recruitment (end of 1985) 20,060 male and female employees aged 17-65 from 52 industrial companies in Westfalia have participated. The voluntary examination at the start of the observation period includes a standardised questionnaire, a physical examination, blood pressure measurements and an ECG. Blood samples are taken after an overnight fast. The data presented here describe the longitudinal evaluation of initially healthy men aged 40 to 65 who had suffered no myocardial infarction or stroke before the examination. In an uniform follow-up period of four years 73 myocardial infarctions and coronary deaths were observed while 2681 men had survived without myocardial infarction or stroke. By far the best single parameter for establishing a risk group was HDL cholesterol. Using the characteristic hyper/dyslipoproteinemia which means cholesterol greater than = 300 mg/dl or HDL cholesterol less than 35 mg/dl combined with cholesterol greater than = 200 mg/dl and/or triglyceride greater than = 200 mg/dl or a multiple logistic function including age, cholesterol, HDL cholesterol, systolic blood pressure, cigarette smoking, diabetes mellitus, angina pectoris and a family history of myocardial infarction patients at high risk for coronary heart disease could be identified. More than two thirds of new events happened in each of these high risk subgroups, which comprise less than 20 percent of men under consideration each.
自1979年起开展的“明斯特心血管病前瞻性研究”(PROCAM)中,对员工进行了心血管危险因素检查,并对动脉粥样硬化临床显著体征(心肌梗死、中风、冠状动脉性死亡)的发生情况进行观察。截至招募结束(1985年底),来自威斯特法伦州52家工业公司的20060名年龄在17至65岁之间的男女员工参与了研究。观察期开始时的自愿检查包括标准化问卷、体格检查、血压测量和心电图检查。在禁食过夜后采集血样。此处呈现的数据描述了对40至65岁、检查前未发生过心肌梗死或中风的初发健康男性的纵向评估。在四年的统一随访期内,观察到73例心肌梗死和冠状动脉性死亡,而2681名男性未发生心肌梗死或中风存活下来。到目前为止,用于建立风险组的最佳单一参数是高密度脂蛋白胆固醇。利用特征性的高/血脂蛋白血症,即胆固醇≥300mg/dl或高密度脂蛋白胆固醇<35mg/dl,同时胆固醇≥200mg/dl和/或甘油三酯≥200mg/dl,或者使用包含年龄、胆固醇、高密度脂蛋白胆固醇、收缩压、吸烟、糖尿病、心绞痛以及心肌梗死家族史的多元逻辑函数,可以识别出冠心病高危患者。这些高危亚组中每组发生的新事件超过三分之二,而每个亚组所包含的男性在研究对象中均不到20%。