Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Auf´m Hennekamp 65, 40225, Düsseldorf, Germany.
Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany.
Cardiovasc Diabetol. 2024 Mar 30;23(1):110. doi: 10.1186/s12933-024-02179-1.
The reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes.
Using data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression.
There were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345-374) to 236 (226-245) per 100,000 person years. In men with diabetes, IR decreased only in 2013-2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009-2012, and slightly decreased in 2013-2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22-1.61) in 1985-1988 to 2.60 (2.26-2.99) in 1997-2000 and moderately decreased in 2013-2016: RR: 1.75 (1.47-2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI.
Over the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained.
降低心肌梗死（MI）发生率和缩小糖尿病患者与非糖尿病患者之间的差距是糖尿病治疗的重要目标。我们分析了人群中首次心肌梗死（包括非致死性 MI 和致死性 MI）以及糖尿病患者与非糖尿病患者中首次非致死性 MI 和致死性 MI 的性别特异性发病率（IR）的时间趋势。
利用德国奥格斯堡 KORA 心肌梗死登记处的数据，我们使用泊松回归估计了 1985 年至 2016 年间有和无糖尿病患者的年龄调整发病率（IR）、相应的相对风险（RR）和时间趋势。
在 1985 年至 2016 年期间，共有 19683 人发生首次 MI（34%为致死性 MI，71%为男性，30%患有糖尿病）。在整个研究人群中，首次 MI 的 IR 从 359（95%CI：345-374）降至 236（226-245）/100000 人年。在患有糖尿病的男性中，IR 仅在 2013-2016 年下降。这是由于首次非致死性 MI，在患有糖尿病的男性中，IR 在 2009-2012 年之前增加，在 2013-2016 年略有下降。总体而言，致死性 MI 的下降幅度大于首次非致死性 MI，对应的发病率。RR 在男性中从 1985-1988 年的 1.40（1.22-1.61）大幅增加至 1997-2000 年的 2.60（2.26-2.99），并在 2013-2016 年适度下降：RR：1.75（1.47-2.09）。在女性中，RR 没有观察到一致的时间趋势。RR 的时间趋势与首次非致死性 MI 和致死性 MI 相似。
在研究期间，我们发现整个研究人群的首次 MI 和致死性 MI 发病率均有所下降。糖尿病男性中首次非致死性 MI 的最初增加需要进一步研究。糖尿病患者与非糖尿病患者之间的差距仍然存在。
Zotero 插件
