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心肌梗死后胆固醇水平的预后重要性。

Prognostic importance of cholesterol levels after myocardial infarction.

作者信息

Ulvenstam G, Bergstrand R, Johansson S, Vedin A, Wilhelmsson C, Wedel H, Aberg A, Wilhelmsen L

出版信息

Prev Med. 1984 Jul;13(4):355-66. doi: 10.1016/0091-7435(84)90027-6.

Abstract

The aim of this study was to analyze the relationship between serum cholesterol level and all causes mortality in men who sustained a first myocardial infarction. The cholesterol distribution 3 months after the infarction was established. Ten annual cohorts (n = 1,204) were followed for a maximum period of 11 years. Secondary risk factors were comparable among the groups of the serum cholesterol distribution quintiles according to a multiple logistic prognostic function based on left heart failure, atrial fibrillation, breathlessness on infarction, maximum S-ASAT, relative heart size, and a history of hypertension. When all ages were analyzed together, the total mortality was higher in the upper cholesterol quintiles (P = 0.02). This association was confirmed when analyzed with Coxian adjustments for age, change in smoking habits after infarction, and the previously mentioned prognostic function. When broken down by age (less than or equal to 49, 50-59, greater than or equal to 60) and period of follow-up (3-24 and 25-84 months), the association between mortality and cholesterol quintiles was confined to patients under 50 years during the late follow-up period (P = 0.01), whereas there was no association for the other age groups.

摘要

本研究的目的是分析首次发生心肌梗死的男性患者血清胆固醇水平与全因死亡率之间的关系。确定了心肌梗死后3个月的胆固醇分布情况。对10个年度队列(n = 1204)进行了为期最长11年的随访。根据基于左心衰竭、心房颤动、梗死后呼吸困难、最大S-ASAT、相对心脏大小和高血压病史的多重逻辑预后函数,各血清胆固醇分布五分位数组之间的次要危险因素具有可比性。当对所有年龄进行综合分析时,胆固醇五分位数较高组的总死亡率更高(P = 0.02)。在用Coxian方法对年龄、梗死后吸烟习惯的变化以及上述预后函数进行调整后分析时,这一关联得到了证实。当按年龄(小于或等于49岁、50 - 59岁、大于或等于60岁)和随访期(3 - 24个月和25 - 84个月)进行细分时,死亡率与胆固醇五分位数之间的关联仅限于随访后期年龄小于50岁的患者(P = 0.01),而其他年龄组则无此关联。

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