Kallio V, Hämäläinen H, Hakkila J, Luurila O J
Lancet. 1979 Nov 24;2(8152):1091-4. doi: 10.1016/s0140-6736(79)92502-9.
375 consecutive patients below 65 years who had an acute myocardial infarction (AMI) took part in a randomised rehabilitation and secondary prevention trial (part of a W.H.O.-coordinated project) designed to study the effects of a multifactorial intervention programme on morbidity, mortality, return to work, &c. After three years' follow-up the cumulative coronary mortality was significantly smaller in the intervention group than in the controls (18.6% versus 29.4%, p = 0.02). This difference was mainly due to a reduction of sudden deaths in the intervention group (5.8% versus 14.4%, p less than 0.01). The reduction was greatest during the first six months after AMI. 18.1% in the intervention group and 11.2% in the controls (p less than 0.10) presented with non-fatal reinfarctions. The number of patients with new Q-QS findings at the end of the three years was, however, almost the same in both groups. The results suggest that organised aftercare during the first six months after AMI with special emphasis on optimum medical control and health education contributes significantly to a reduction in the number of sudden deaths.
375名年龄在65岁以下的急性心肌梗死（AMI）患者参与了一项随机康复与二级预防试验（该试验是世界卫生组织协调项目的一部分），旨在研究多因素干预方案对发病率、死亡率、重返工作岗位等方面的影响。经过三年的随访，干预组的累积冠状动脉死亡率显著低于对照组（分别为18.6%和29.4%，p = 0.02）。这种差异主要是由于干预组猝死人数减少（分别为5.8%和14.4%，p小于0.01）。这种减少在急性心肌梗死后的头六个月最为明显。干预组有18.1%的患者出现非致命性再梗死，对照组为11.2%（p小于0.10）。然而，三年结束时两组出现新的Q-QS表现的患者数量几乎相同。结果表明，在急性心肌梗死后的头六个月进行有组织的后续护理，特别强调最佳医疗控制和健康教育，对减少猝死人数有显著贡献。
