School of Nursing, Hanyang University, Seoul 04763, Korea.
College of Nursing, Kyoungdong University, Wonju 26495, Korea.
Int J Environ Res Public Health. 2020 Nov 22;17(22):8670. doi: 10.3390/ijerph17228670.
Early risk stratification and preventative strategies are required in patients with ischemic heart disease (IHD) to prevent heart failure (HF). We aimed to investigate the rate of progression to HF and to investigate the factors predicting the development of HF in a population with IHD for 10 years. A descriptive study was conducted using Korea National Health Insurance Service-National Sample Cohort (NHI-NSC) data (2005-2015). Among the patients diagnosed with IHD for the first time in 2005-2006, 2271 men and 2037 women who responded to the health check-up survey were finally selected. Cox Proportional Hazard regression analyses and the Kaplan-Meier survival analysis were used. HF incidence rates were 5.1% in men and 8.0% in women. The mean duration of transition to HF was 4.85 ± 2.73 years in men and 4.73 ± 2.73 years in women. The non-incidence rate of HF was higher in men than in women (Log-rank test, = 0.0003). Bivariate analyses showed that older age, prevalence of hypertension and diabetes, less alcohol, and lower physical exercise were associated with the incidence of HF in both men and women. Multivariate analyses found that HF incidence in aged subjects ≥70 years was 1.46 times higher in men and 1.44 times higher in women compared to those in their 30 s ( < 0.001). Prevalence of hypertension reduced the incidence of HF by 0.78 and 0.87 for men and women, respectively. The prevalence of diabetes increased 1.23 times only in men. These findings suggest that special attention such as periodic counseling and education is needed to prevent progression to HF in elderly and diabetic patients during follow-up after IHD.
患有缺血性心脏病（IHD）的患者需要早期进行风险分层和预防策略，以预防心力衰竭（HF）。我们旨在研究 10 年内患有 IHD 的人群中 HF 进展的发生率，并研究预测 HF 发生的因素。本研究采用韩国国家健康保险服务-国家样本队列（NHI-NSC）数据（2005-2015 年）进行描述性研究。在 2005-2006 年首次被诊断为 IHD 的患者中，最终选择了 2271 名男性和 2037 名女性接受健康检查调查。采用 Cox 比例风险回归分析和 Kaplan-Meier 生存分析。男性 HF 发生率为 5.1%，女性为 8.0%。男性向 HF 转变的平均时间为 4.85±2.73 年，女性为 4.73±2.73 年。男性 HF 无发生率高于女性（Log-rank 检验， < 0.0003）。双变量分析显示，年龄较大、高血压和糖尿病的患病率、较少饮酒和较低的体育锻炼与男性和女性 HF 的发生有关。多变量分析发现，年龄≥70 岁的男性和女性 HF 发生率分别比 30 多岁的男性和女性高 1.46 倍和 1.44 倍（ < 0.001）。高血压的患病率使男性和女性的 HF 发生率分别降低了 0.78 和 0.87。糖尿病的患病率仅使男性增加了 1.23 倍。这些发现表明，在 IHD 后随访期间，对于老年和糖尿病患者，需要特别注意，如定期咨询和教育，以预防 HF 的进展。
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