Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.
Universidade Federal do Rio Grande, Rio Grande, RS - Brasil.
Arq Bras Cardiol. 2020 Nov;115(5):916-924. doi: 10.36660/abc.20190573.
ST-segment elevation myocardial infarction (STEMI) is one of the main clinical manifestations of ischemic heart disease. Population-based data are relevant to better understand the current epidemiology of this condition.
To describe the incidence, therapeutic management, hospital clinical outcomes and cardiovascular events in the first year of follow-up of individuals hospitalized for STEMI.
Population-based prospective cohort study with consecutive registries of hospitalization for STEMI in a city in southern Brazil from 2011 to 2014. It included patients with STEMI who presented acute myocardial ischemia symptoms in the last 72 hours. A p-value < 0.05 was considered significant.
The annual incidence of STEMI hospitalizations was 108 cases per 100,000 inhabitants. Adjusted incidence was higher among older individuals (relative risk 64.9; 95% CI 26.9-156.9; p for linear trend < 0.001) and among men (relative risk 2.8; 95% CI 2.3-3.3; p < 0.001). There were 530 hospitalizations in the period under evaluation and the reperfusion rate reached 80.9%. Hospital mortality and the one-year follow-up cardiovascular event rate were, respectively, 8.9% and 6.1%. The oldest patients had higher hospital mortality (relative risk 3.72; 95% CI 1.57-8.82; p for linear trend = 0.002) and more one-year follow-up cardiovascular events (hazard ratio 2.35; 95% CI 1.12-4.95; p = 0.03).
This study shows that both the therapeutic approach and hospital mortality are similar to the ones found in developed countries. However, the hospitalization rate was higher in these countries.
ST 段抬高型心肌梗死（STEMI）是缺血性心脏病的主要临床表现之一。基于人群的数据对于更好地了解该疾病的当前流行病学情况至关重要。
描述巴西南部一个城市 2011 年至 2014 年因 STEMI 住院患者的发病率、治疗管理、医院临床结局和心血管事件发生情况。
这是一项基于人群的前瞻性队列研究，连续登记了该城市因 STEMI 住院的患者。研究对象为在过去 72 小时内出现急性心肌缺血症状的 STEMI 患者。p 值<0.05 为差异有统计学意义。
STEMI 住院的年发病率为每 10 万人中有 108 例。校正发病率在年龄较大的个体（相对风险 64.9；95%置信区间 26.9-156.9；p 趋势检验<0.001）和男性中较高（相对风险 2.8；95%置信区间 2.3-3.3；p<0.001）。在评估期间共发生了 530 例住院事件，再灌注率达到 80.9%。住院死亡率和 1 年随访心血管事件发生率分别为 8.9%和 6.1%。最年长的患者住院死亡率更高（相对风险 3.72；95%置信区间 1.57-8.82；p 趋势检验=0.002），1 年随访时心血管事件更多（风险比 2.35；95%置信区间 1.12-4.95；p=0.03）。
本研究表明，治疗方法和住院死亡率与发达国家相似，但这些国家的住院率更高。
