分析过去三十年在赫罗纳省的心肌梗死发病率和病死率。

Analysis of myocardial infarction incidence and case-fatality in the last three decades in the province of Girona.

机构信息

Grup d'Estudi REGICOR, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Doctoral College, University of Vic-Central University of Catalonia (Uvic-UCC), Vic, Barcelona, Spain.

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Grup d'Epidemiologia i Genètica Cardiovascular, Institut de Recerca Hospital del Mar (IMIM), Barcelona, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2024 Jun;77(6):450-458. doi: 10.1016/j.rec.2023.10.005. Epub 2023 Nov 21.

DOI:10.1016/j.rec.2023.10.005

PMID:37981192

Abstract

INTRODUCTION AND OBJECTIVES

Myocardial infarction (MI) incidence and case fatality trends are highly informative but relatively untested at the population level. The objective of this work was to estimate MI incidence and case fatality in the Girona population aged 35-74 years, and to determine their 30-year trends (1990-2019).

METHODS

The REGICOR (Girona Heart Registry) monitored MI incidence and case fatality rates from 1990 to 2008. For the period 2008 to 2019, we linked discharges from Girona hospitals (n=4 974 977) and mortality registry (n=70 405) during this period. Our linkage algorithm selected key MI diagnostic codes and removed duplicates. Estimates from the linkage algorithm and the REGICOR registry were compared using chi-square tests for overlapping years (2008-2009). We estimated the annual percent change (APC) of standardized MI incidence and 28-day case fatality, and analyzed their trends using joinpoint regression.

RESULTS

MI incidence and case fatality estimates were similar in the linkage algorithm and the REGICOR registry. We observed significant decreasing trends in the incidence of MI. The trend was APC, -0.96% (95% confidence interval (95%CI), -1.4 to -0.53) in women from 1990 to 2019 and -4.2% (95%CI, -5.5 to -3.0) in men from 1994 to 2019. The largest decrease in case fatality was -3.8% (95%CI, -5.1 to -2.5) from 1995 to 2003 in women and -2.4% (95%CI, -2.9 to -1.9) from 1995 to 2004 in men, mainly due to prehospital case fatality declines: -1.8% (95%CI, -2.6 to -1.1) in men and -3.2% (95%CI, -4.6 to -1.8) in women.

CONCLUSIONS

In Girona, MI incidence and case fatality decreased between 1990 and 2019. The incidence showed a slow but continuous decrease while case fatality only stabilized in the last decade, particularly in women.

摘要

简介和目的

心肌梗死（MI）的发病率和病死率趋势具有高度信息性，但在人群水平上的检验相对较少。本研究的目的是估计 35-74 岁吉罗纳人群的 MI 发病率和病死率，并确定其 30 年的趋势（1990-2019 年）。

方法

REGICOR（吉罗纳心脏登记处）监测了 1990 年至 2008 年期间的 MI 发病率和病死率。对于 2008 年至 2019 年期间，我们将吉罗纳医院的出院记录（n=4974977）和死亡登记处（n=70405）进行了链接。我们的链接算法选择了关键的 MI 诊断代码并去除了重复项。使用卡方检验比较链接算法和 REGICOR 登记处的重叠年份（2008-2009 年）的估计值。我们估计了标准化 MI 发病率和 28 天病死率的年变化百分比（APC），并使用连接点回归分析了它们的趋势。

结果

链接算法和 REGICOR 登记处的 MI 发病率和病死率估计值相似。我们观察到 MI 发病率呈显著下降趋势。女性的趋势为 APC，-0.96%（95%置信区间[95%CI]，-1.4 至-0.53），男性为 1994 年至 2019 年的-4.2%（95%CI，-5.5 至-3.0）。女性的病死率降幅最大，为 1995 年至 2003 年的-3.8%（95%CI，-5.1 至-2.5），男性为 1995 年至 2004 年的-2.4%（95%CI，-2.9 至-1.9），主要归因于院前病死率的下降：男性为-1.8%（95%CI，-2.6 至-1.1），女性为-3.2%（95%CI，-4.6 至-1.8）。