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丹麦肥厚型心肌病的时间趋势:一项全国性回顾性队列研究。

Temporal trends of hypertrophic cardiomyopathy in Denmark: a nationwide retrospective cohort study.

机构信息

Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark

Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.

出版信息

BMJ Open. 2023 Sep 4;13(9):e074010. doi: 10.1136/bmjopen-2023-074010.

Abstract

OBJECTIVES

To describe the population of patients diagnosed with hypertrophic cardiomyopathy (HCM) in Denmark and determine temporal trends in incidence and patient characteristics over time.

DESIGN

Nationwide retrospective cohort study.

SETTING

Danish nationwide administrative and clinical registers and databases.

PARTICIPANTS

All patients aged ≥16 years diagnosed with HCM from 2005 to 2018.

OUTCOMES MEASURES

Time trends in HCM diagnosis, patient characteristics, comorbidities and pharmacotherapy were identified and tested for significance using the Cochran-Armitage trend test.

RESULTS

3856 HCM patients were included (median age 68 years (IQR 56-78)). Although there were more males (53%), females were older (72 years vs 63 years) and more likely to have their type of HCM classified as obstructive (54% vs 38%). A consistent rise in HCM cases per year was detected and there was a significant decline in prevalence of heart failure (2005: 20% to 2018: 12%, p<0.001) and ischaemic heart disease (2005: 31% to 2019: 16%, p≤0.001). Prevalence of atrial fibrillation and stroke remained notable and unchanged. Lastly, the rate of hospitalisations decreased over time (2005: 64% to 2016: 46%, p<0.001), while the rate of outpatient follow-up increased (2005: 81% to 2016: 87%, p 0.003).

CONCLUSION

There was a consistent rise in HCM cases with decreasing morbidity burden. Females were older at diagnosis and more likely to have their type of HCM classified as obstructive. The rate of outpatient follow-up is increasing.

摘要

目的

描述丹麦诊断为肥厚型心肌病(HCM)患者的人群,并确定发病率的时间趋势以及随时间推移的患者特征变化。

设计

全国性回顾性队列研究。

设置

丹麦全国性行政和临床登记处及数据库。

参与者

2005 年至 2018 年期间诊断为 HCM 的所有≥16 岁患者。

结局测量

使用 Cochran-Armitage 趋势检验,确定并检验 HCM 诊断、患者特征、合并症和药物治疗的时间趋势。

结果

共纳入 3856 例 HCM 患者(中位年龄 68 岁(IQR 56-78))。尽管男性占多数(53%),但女性年龄更大(72 岁比 63 岁),且更有可能存在梗阻型 HCM(54%比 38%)。每年 HCM 病例数持续增加,心力衰竭的患病率显著下降(2005 年:20%至 2018 年:12%,p<0.001),缺血性心脏病的患病率也显著下降(2005 年:31%至 2019 年:16%,p≤0.001)。心房颤动和中风的患病率仍然很高且无变化。最后,住院率随时间降低(2005 年:64%至 2016 年:46%,p<0.001),而门诊随访率增加(2005 年:81%至 2016 年:87%,p<0.001)。

结论

HCM 病例持续增加,发病负担降低。女性诊断时年龄更大,更有可能存在梗阻型 HCM。门诊随访率在增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5603/10481739/ac61f2ab4ae7/bmjopen-2023-074010f01.jpg

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