Mori Hiroyoshi, Suzuki Hiroshi, Nishihira Kensaku, Honda Satoshi, Kojima Sunao, Takegami Misa, Takahashi Jun, Itoh Tomonori, Watanabe Tetsu, Takenaka Takashi, Ito Masaaki, Takayama Morimasa, Kario Kazuomi, Sumiyoshi Tetsuya, Kimura Kazuo, Yasuda Satoshi
Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Int J Cardiol Hypertens. 2020 Jun 24;6:100039. doi: 10.1016/j.ijchy.2020.100039. eCollection 2020 Sep.
Hypertension, diabetes, dyslipidemia and smoking are established coronary risk factors for coronary heart disease in the general population. However, in Japanese patients with acute myocardial infarction (AMI), the impact of the number of coronary risk factors on in-hospital morality remains unclear.
The Japan Acute Myocardial Infarction Registry (JAMIR) is a nationwide real-world database. We examined the association between the number of coronary risk factors and in-hospital mortality.
Data were obtained from total of 20462 AMI patients (mean age, 68.8 ± 13.3 years old; 15281 men, 5181 women). The prevalence of hypertension increased with advancing age, while the prevalence of smoking decreased with advancing age. The prevalence of diabetes and dyslipidemia were highest in middle age. A majority (76.9%) of the patients with AMI had at least 1 of these coronary risk factors. Overall, the number of coronary risk factor was relatively less in older subjects and women under 50 years old. Crude in-hospital mortality rates were 10.7%, 10.5%, 7.2%, 5.0% and 4.5% with 0, 1, 2, 3 and 4 risk factors, respectively. After adjusting for age and sex, there was an inverse association between the number of coronary risk factors and the in-hospital mortality (adjusted odds ratio [1.68; 95% confidence interval, 1.20-2.35] among individuals with 0 vs. 4 risk factors).
In the present study of Japanese patients with AMI, who received modern medical treatment, in-hospital mortality was inversely related to the number of coronary risk factors. To investigate the underlying reasons for these findings, further studies are needed.
高血压、糖尿病、血脂异常和吸烟是一般人群中已确定的冠心病冠状动脉危险因素。然而，在日本急性心肌梗死（AMI）患者中，冠状动脉危险因素数量对住院死亡率的影响仍不清楚。
日本急性心肌梗死登记处（JAMIR）是一个全国性的真实世界数据库。我们研究了冠状动脉危险因素数量与住院死亡率之间的关联。
共纳入20462例AMI患者的数据（平均年龄68.8±13.3岁；男性15281例，女性5181例）。高血压患病率随年龄增长而增加，而吸烟患病率随年龄增长而降低。糖尿病和血脂异常患病率在中年时最高。大多数（76.9%）AMI患者至少有其中一种冠状动脉危险因素。总体而言，老年受试者和50岁以下女性的冠状动脉危险因素数量相对较少。冠状动脉危险因素数量为0、1、2、3和4时，粗住院死亡率分别为10.7%、10.5%、7.2%、5.0%和4.5%。在调整年龄和性别后，冠状动脉危险因素数量与住院死亡率之间存在负相关（0个危险因素与4个危险因素个体的调整比值比[1.68；95%置信区间，1.20 - 2.35]）。
在本项针对接受现代医学治疗的日本AMI患者的研究中，住院死亡率与冠状动脉危险因素数量呈负相关。为探究这些发现的潜在原因，需要进一步研究。
