年龄≥55岁的男性和女性中显性与未诊断心肌梗死的发生率:鹿特丹研究

作     者：De Torbal A. Boersma E. Kors J.A. J.C.M. Witteman 王睿 

作者机构：Department of Epidemiology and Biostatistics Erasmus MC PO Box 1738 3000 DR Rotterdam Netherlands 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第8期

页      面：26-27页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：心肌梗死 发生率 鹿特丹 显性 女性 男性 年龄 12导联心电图 未诊断 

摘      要：Aims: Contemporary data on the incidence of unrecognized myocardial infarction(MI) among subjects aged 55 and older are limited. Methods and results: We studied the incidence of recognized and unrecognized MI in the Rotterdam Study, a population-based cohort of men and women aged 55 and older. The baseline examination was performed during 1990-93, with follow-up examinations during 1994- 95, and 1997-2000. Baseline and follow-up 12-lead ECGs were analysed by the Modular ECG Analysis System. The 5148 participants who had no evidence of prevalent infarction were the subjects for analysis. Incident recognized infarction was defined as the occurrence of a fatal or non-fatal event coded as 121 according to the International Classification of Diseases, 10th edition. A repeat ECG was available in 4187 subjects. An unrecognized infarction was considered to have occurred if there was electrocardiographic evidence in the absence of a clinically recognized event. During a median follow-up of 6.4 years, 141 incident recognized infarctions occurred and the incidence rate of this event was 5.0 per 1000 person years. The incidence was higher in men(8.4) than in women(3.1). The incidence rate of unrecognized infarction was 3.8 per 1000 person years. Men(4.2) and women(3.6) had approximately similar incidence. Hence, the proportion of unrecognized infarction was lower in men(33% ) than in women(54% ). This difference in proportion of unrecognized infarctions was independent of age. Conclusion: A high proportion of incident MIs remains clinically unrecognized. As a history of MI is associated with an increased risk of repeat cardiovascular complications, our data suggest a need for periodical electrocardiographic screening to recognize(prevalent) infarctions and to install effective preventive treatment in those aged 55 and older.