Herlitz J, Karlson B W, Lindqvist J, Sjölin M
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Eur J Emerg Med. 1997 Dec;4(4):196-203. doi: 10.1097/00063110-199712000-00004.
The aim of this study was to describe mortality, mode of death and risk indicators for death during 5 years of follow-up among men and women coming to the emergency department with chest pain or other symptoms raising suspicion of acute myocardial infarction (AMI). During the 21 months of the study, all patients who came to the medical emergency department of one single hospital with chest pain or other symptoms suggestive of AMI were prospectively followed for 5 years. A total of 5362 patients came on 7157 occasions; men accounted for 55% of the admissions. The 5-year mortality rate was 25.6% for men compared with 25.7% for women. The women were older and had a higher prevalence of known congestive heart failure and hypertension, whereas the prevalence of previous myocardial infarction was higher in men. When correcting for dissimilarities in age and clinical history, male gender appeared as an independent predictor of death. In terms of mode of death men differed from women: more frequently dying at home, more frequently dying in association with ventricular fibrillation and less frequently dying in association with congestive heart failure. However, these differences were to some extent explained by differences in age. Independent risk indicators for death during 5 years of follow-up differed in men and women. It was concluded that in a consecutive series of patients with chest pain or other symptoms suggesting AMI in the emergency department, male gender was an independent risk indicator for death during a 5-year follow-up. This might be explained by a higher occurrence of coronary artery disease in men than in women in this patient population.
本研究的目的是描述因胸痛或其他引发急性心肌梗死（AMI）怀疑症状前来急诊科的男性和女性在5年随访期间的死亡率、死亡方式及死亡风险指标。在研究的21个月中，对所有因胸痛或其他提示AMI症状前来一家医院急诊科的患者进行了为期5年的前瞻性随访。共有5362例患者前来就诊7157次；男性占入院人数的55%。男性的5年死亡率为25.6%，女性为25.7%。女性年龄较大，已知充血性心力衰竭和高血压的患病率较高，而男性既往心肌梗死的患病率较高。在校正年龄和临床病史的差异后，男性性别成为死亡的独立预测因素。在死亡方式方面，男性与女性不同：更多在家中死亡，更频繁地死于心室颤动，较少死于充血性心力衰竭。然而，这些差异在一定程度上可由年龄差异解释。男性和女性在5年随访期间的独立死亡风险指标有所不同。研究得出结论，在急诊科连续一系列因胸痛或其他提示AMI症状的患者中，男性性别是5年随访期间死亡的独立风险指标。这可能是由于该患者群体中男性冠状动脉疾病的发生率高于女性。
