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JAMA Cardiol:急性心肌梗死患者的10年生存率

2022-05-13 Nebula MedSci原创

在过去几十年中,急性心肌梗死后幸存者的10年死亡率和AMI复发住院率均有所降低。

得益于医疗技术的发展,急性心肌梗死 (AMI) 患者的短期预后有所改善,但我们对其长期预后的情况还知之甚少,关于该问题的大规模研究也较少。

本研究旨在评估AMI患者的10年全因死亡率和AMI复发住院率,同时检验复发和死亡率之间的相关性。

纳入了1995年至2019年急性心肌梗死后幸存的医保患者,根据年龄、性别、种族、区域划分亚组。于2020年10月至2022年2月进行数据分析。主要终点是急性心肌梗死入院30天后至10年的全因死亡率和AMI复发住院率。


AMI后的10年死亡率和复发率

共纳入了3982266位急性心肌梗死幸存者,其中1952450位(49.0%)是女性,平均78.0岁。10年死亡率和AMI复发率分别是72.7%和27.1%。校正的死亡率每年降低1.5%,AMI复发率每年降低2.7%。在平衡了患者特征的亚组分析中,死亡率和复发率的风险比(HR):男性 vs 女性=1.13:1.07,黑人 vs 白人=1.05 vs 1.08,其他种族 vs 白人=0.96 vs 1.00, 医疗发达区 vs 其他地区=1.06 vs 1.00。


不同亚组的10年死亡率和复发率

2007年至2009年住院的患者的10年死亡风险比1995年至1997年住院的患者低13.9%(校正风险比 0.86),10年复发率降低了22.5%(校正风险比 0.77)。复发性心肌梗死患者的10年(从初发AMI后开始)死亡率高于无复发性心肌梗死患者(80.6% vs 72.4%)。

综上,该研究显示在过去几十年中,急性心肌梗死后幸存者的10年死亡率和AMI复发住院率均有所降低。

 

原始出处:

Wang Y, Leifheit EC, Krumholz HM. Trends in 10-Year Outcomes Among Medicare Beneficiaries Who Survived an Acute Myocardial Infarction. JAMA Cardiol. Published online May 04, 2022. doi:10.1001/jamacardio.2022.0662.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1782159, encodeId=5a6c1e82159be, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Thu Jan 05 13:57:13 CST 2023, time=2023-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220269, encodeId=a625122026995, content=学习了,真是好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37515579911, createdName=ms1000001982939558, createdTime=Tue May 17 12:13:10 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219494, encodeId=52cd1219494f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220513/be4942d142634687973f7462d3f25fb7/0fd1fce2657444da8ee2847630587075.jpg, createdBy=f9834909694, createdName=zhaomh770719, createdTime=Fri May 13 23:41:49 CST 2022, time=2022-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256899, encodeId=75871256899b2, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Mon May 09 07:57:13 CST 2022, time=2022-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243492, encodeId=46eb1243492af, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat May 07 19:57:13 CST 2022, time=2022-05-07, status=1, ipAttribution=)]
    2022-05-17 ms1000001982939558

    学习了,真是好的文章

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1782159, encodeId=5a6c1e82159be, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Thu Jan 05 13:57:13 CST 2023, time=2023-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220269, encodeId=a625122026995, content=学习了,真是好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37515579911, createdName=ms1000001982939558, createdTime=Tue May 17 12:13:10 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219494, encodeId=52cd1219494f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220513/be4942d142634687973f7462d3f25fb7/0fd1fce2657444da8ee2847630587075.jpg, createdBy=f9834909694, createdName=zhaomh770719, createdTime=Fri May 13 23:41:49 CST 2022, time=2022-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256899, encodeId=75871256899b2, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Mon May 09 07:57:13 CST 2022, time=2022-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243492, encodeId=46eb1243492af, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat May 07 19:57:13 CST 2022, time=2022-05-07, status=1, ipAttribution=)]
    2022-05-13 zhaomh770719

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1782159, encodeId=5a6c1e82159be, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Thu Jan 05 13:57:13 CST 2023, time=2023-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220269, encodeId=a625122026995, content=学习了,真是好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37515579911, createdName=ms1000001982939558, createdTime=Tue May 17 12:13:10 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219494, encodeId=52cd1219494f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220513/be4942d142634687973f7462d3f25fb7/0fd1fce2657444da8ee2847630587075.jpg, createdBy=f9834909694, createdName=zhaomh770719, createdTime=Fri May 13 23:41:49 CST 2022, time=2022-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256899, encodeId=75871256899b2, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Mon May 09 07:57:13 CST 2022, time=2022-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243492, encodeId=46eb1243492af, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat May 07 19:57:13 CST 2022, time=2022-05-07, status=1, ipAttribution=)]
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    2022-05-07 肿瘤克星

    JAMA上文章都是顶级的,谢谢梅斯及时上新

    0

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