Cambou J P, Lablache-Combier B, Marques-Vidal P, Ruidavets J B, Branchu M P, Ferrières J
INSERM U-326, ORSMIP, CHU Purpan, Toulouse.
Ann Cardiol Angeiol (Paris). 1994 Dec;43(10):588-93.
The MONICA Haute-Garonne Centre studied the incidence of myocardial infarction and death from coronary heart disease in 1,762 cases between 1985 and 1989. Changes in treatment were analysed in the subgroup of 416 patients admitted to hospital for myocardial infarction in 1986 and in 1989. The incidence of myocardial infarction decreased in men from 218.4 to 183.9 per 100,000 inhabitants (p < 0.01) and decreased nonsignificantly in women from 19.3 to 23.2 per 100,000 inhabitants (NS). The decreased incidence of myocardial infarction in men was exclusively due to a decrease by one-third of the incidence of infarction in patients with diagnosed coronary heart disease. Although the community mortality remained stable, the hospital mortality decreased by one half in man between 1985 and 1989 (21% versus 10%, respectively, p < 0.001). Between 1986 and 1989, the prescription of acetylsalicylic acid during the acute phase increased threefold (26.4% versus 72.9%, p < 0.001) and increased fivefold when coprescribed with fibrinolytics. Similarly, the prescription of aspirin on discharge from hospital doubled (from 32.6% to 69.5%, p < 0.001). The dosage of aspirin decreased from 500 mg or more per day in 1986 to a daily dose of approximately 250 mg in 1989. Lysine acetylsalicylate was the form most widely prescribed. In this population, patients treated by antithrombotics (aspirin or fibrinolytics) had a more favourable prognosis than patients not receiving any of these treatments. The changes observed in this study population are in line with the published results of therapeutic trials on antithrombotics in the acute phase of myocardial infarction and in the postinfarction phase (GISSI2, ISIS2).
莫妮卡上加龙省中心研究了1985年至1989年间1762例心肌梗死和冠心病死亡的发病率。对1986年和1989年因心肌梗死住院的416例患者亚组的治疗变化进行了分析。男性心肌梗死发病率从每10万居民218.4例降至183.9例（p<0.01），女性从每10万居民19.3例降至23.2例，下降不显著（无统计学意义）。男性心肌梗死发病率下降完全是由于已确诊冠心病患者的梗死发病率下降了三分之一。尽管社区死亡率保持稳定，但1985年至1989年间男性的医院死亡率下降了一半（分别为21%和10%，p<0.001）。1986年至1989年间，急性期乙酰水杨酸的处方量增加了两倍（从26.4%增至72.9%，p<0.001），与纤维蛋白溶解剂合用时增加了五倍。同样，出院时阿司匹林的处方量增加了一倍（从32.6%增至69.5%，p<0.001）。阿司匹林的剂量从1986年的每天500毫克或更多降至1989年的每天约250毫克。乙酰水杨酸赖氨酸盐是最广泛使用的剂型。在该人群中，接受抗血栓药物（阿司匹林或纤维蛋白溶解剂）治疗的患者预后比未接受任何此类治疗的患者更好。本研究人群中观察到的变化与心肌梗死急性期和心肌梗死后抗血栓药物治疗试验的已发表结果（GISSI2、ISIS2）一致。
