Coughlin S S, Neaton J D, Sengupta A, Kuller L H
Department of Biostatistics and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112.
Am J Epidemiol. 1994 Jan 15;139(2):166-72. doi: 10.1093/oxfordjournals.aje.a116978.
Possible predictors of mortality from idiopathic dilated cardiomyopathy were studied in 356,222 men who were screened as part of the Multiple Risk Factor Intervention Trial. The vital status of each member of this cohort was ascertained through 1986. Death certificates were obtained from state health departments and coded by a trained nosologist. Individuals with a history of myocardial infarction were excluded. A total of 206 deaths due to idiopathic dilated cardiomyopathy occurred in the cohort of 356,222 men after an average of 12 years of follow-up. The age-specific rates of mortality from idiopathic dilated cardiomyopathy increased from 0.10 per 10,000 person-years among men aged 35-39 years to 1.16 per 10,000 person-years among men aged 55-57 years. The proportional hazards model was used to obtain adjusted estimates of relative risks. Statistically significant, independent associations were observed with cigarettes smoked per day (p < 0.001), diastolic blood pressure (p < 0.001), and diabetes mellitus (relative risk (RR) = 2.97, p < 0.001). Black race was also associated with an increased risk of death from idiopathic dilated cardiomyopathy (RR = 1.59 and p = 0.045 without adjustment for income; RR = 1.58 and p = 0.058 with adjustment for income). No association was found with serum cholesterol or income. The information about possible risk factors obtained in this study may contribute to future preventive programs for idiopathic dilated cardiomyopathy.
在作为多重危险因素干预试验一部分接受筛查的356,222名男性中，对特发性扩张型心肌病的可能死亡预测因素进行了研究。该队列中每位成员的生命状态截至1986年已确定。死亡证明从州卫生部门获取，并由一名经过培训的疾病分类学家进行编码。有心肌梗死病史的个体被排除在外。在平均12年的随访后，356,222名男性队列中共有206例因特发性扩张型心肌病死亡。特发性扩张型心肌病的年龄别死亡率从35 - 39岁男性中的每10,000人年0.10例增加到55 - 57岁男性中的每 10,000人年1.16例。使用比例风险模型获得相对风险的调整估计值。观察到与每日吸烟量（p < 0.001）、舒张压（p < 0.001）和糖尿病（相对风险（RR）= 2.97，p < 0.001）存在统计学显著的独立关联。黑人种族也与特发性扩张型心肌病死亡风险增加相关（未调整收入时RR = 1.59，p = 0.045；调整收入时RR = 1.58，p = 0.058）。未发现与血清胆固醇或收入有关联。本研究中获得的关于可能风险因素的信息可能有助于未来针对特发性扩张型心肌病的预防项目。
