中青年人群发生急性心肌梗死的危险因素分析
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摘要
目的:分析中青年人群发生急性心肌梗死(AMI)的相关危险因素。方法:应用前瞻性队列研究,从2012-06至2014-10开滦研究中健康查体人群(n=110 100名,年龄18~98岁)中,按男性≤53岁,女性≤63岁的标准,纳入中青年受试者62 208名,随访2年,以发生AMI为研究终点事件,分析中青年人群发生AMI的危险因素。结果:随访期间,有56名发生AMI,为AMI组,62 152名受试者未发生AMI,为正常组。AMI组受试者的年龄、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)水平高于正常组,AMI组的糖尿病病史、服用降压药物的患者比例高于正常组(P均<0.05);Cox比例风险回归分析得出:年龄、男性、LDL-C、TG为中青年人群发生AMI的危险因素[危险比(RR)=1.37、60.54、1.12、5.93,P均<0.05]。结论:年龄、男性、LDL-C、TG为中青年人群发生AMI的危险因素。
Objective: To study the risk factors for prevalence of acute myocardial infarction(AMI) in young and middle-aged population.Methods: A prospective cohort study was conducted in 110100 subjects at the age of(18-98) years who received physical examination in Kailuan Group from 2012-06 to 2014-10. Based on the limitations of male≤53 years and female≤63 years, a total of 62367 subjects were enrolled in our study. The subjects were followed-up for 2 years by the end point event of AMI to analyze the risk factors of AMI occurrence.Results: According to AMI occurrence at the follow-up period, the subjects were divided into 2 groups: AMI group, n=56 and Control group, n=62152. Compared with Control group, AMI group had increased BMI, SBP, DBP and elevated blood levels of LDL-C, TG; AMI group also showed the higher ratios of subjects with the history of diabetes and taking anti-hypertension medication. Cox proportional hazard regression analysis indicated that age(RR=1.37), male(RR=60.54), LDL-C(RR=1.12), and TG(RR=5.93) were the risk factors for AMI occurrence in young and middle-aged population, all P<0.05.Conclusion: Age, male gender, blood levels of LDL-C, and TG were the risk factors for AMI occurrence in young and middleaged population.
Objective: To study the risk factors for prevalence of acute myocardial infarction(AMI) in young and middle-aged population.Methods: A prospective cohort study was conducted in 110100 subjects at the age of(18-98) years who received physical examination in Kailuan Group from 2012-06 to 2014-10. Based on the limitations of male≤53 years and female≤63 years, a total of 62367 subjects were enrolled in our study. The subjects were followed-up for 2 years by the end point event of AMI to analyze the risk factors of AMI occurrence.Results: According to AMI occurrence at the follow-up period, the subjects were divided into 2 groups: AMI group, n=56 and Control group, n=62152. Compared with Control group, AMI group had increased BMI, SBP, DBP and elevated blood levels of LDL-C, TG; AMI group also showed the higher ratios of subjects with the history of diabetes and taking anti-hypertension medication. Cox proportional hazard regression analysis indicated that age(RR=1.37), male(RR=60.54), LDL-C(RR=1.12), and TG(RR=5.93) were the risk factors for AMI occurrence in young and middle-aged population, all P<0.05.Conclusion: Age, male gender, blood levels of LDL-C, and TG were the risk factors for AMI occurrence in young and middleaged population.
引文
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[17]Giampaoli S,Palmieri L,Panico S,et al.Favorable cardiovascular risk profile(low risk)and 10-year stroke incidence in women and men:findings from 12 Italian population studies.Am J Epidemiol,2006,163:893-902.
[18]Neaton JD,Wentworth D.Serum Cholesterol,Blood Pressure,Cigarette Smoking,and Death From Coronary Heart Disease Overall Findings and Differences by Age for 316099 White Men.Arc intern med,1992,152:56.
[19]中国成人血脂异常防治指南制定联合委员会.中国成人血脂异常防治指南.中华心血管病杂志,2007,35:390-419.
[2]Wichmann J,Sj?berg K,Tang L,et al.The effect of secondary inorganic aerosols,soot and the geographical origin of air mass on acute myocardial infarction hospitalisations in Gothenburg,Sweden during1985-2010:a case-crossover study.Environ Health,2014,13:61.
[3]Khot UN,Khot MB,Bajzer CT,et al.Prevalence of conventional risk factors in patients with coronary heart disease.J Am Med Assoc,2003,290:898-904.
[4]吴蕊,杨志明.国人早发冠心病危险因素Meta分析结论.中华心血管病杂志,2008,6:27.
[5]Gupta A,Wang Y,Spertus JA,et al.Trends in acute myocardial infarction in young patients and differences by sex and race,2001 to2010.J Am Coll Cardiol,2014,64:337-345.
[6]Xie J,Wu EQ,Zheng ZJ,et al.Patient-reported health status in coronary heart disease in the United States:age,sex,racial,and ethnic differences.Circulation,2008,118:491-497.
[7]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析.中国循环杂志,2015,30:206-210.
[8]Wilson PWF,D’Agostino RB,Levy D,et al.Prediction of coronary heart disease using risk factor categories.Circulation,1998,97:1837-1847.
[9]Tolstrup JS,Hvidtfeldt UA,Flachs EM,et al.Smoking and risk of coronary heart disease in younger,middle-aged,and older adults.Am J Public Health.2014,104:96-102.
[10]Capewell S,Hayes DK,Ford ES,et al.Life-years gained among USadults from modern treatments and changes in the prevalence of 6coronary heart disease risk factors between 1980 and 2000.Am JEpidemiol,2009,170:229-236.
[11]Kataoka Y,Shao M,Wolski K,et al.Multiple risk factor intervention and progression of coronary atherosclerosis in patients with type 2diabetes mellitus.Eur J prev cardiol,2013,20:209-217.
[12]Ford ES.Trends in Predicted 10-Year Risk of Coronary Heart Disease and Cardiovascular Disease among US Adults from 1999 to 2010.J Am Coll Cardiol,2013,61:2249-2252.
[13]Lloyd-Jones DM,Hong Y,Labarthe D,et al.American Heart Association Strategic Planning Task Force and Statistics Committee Defining and setting national goals for cardiovascular health promotion and disease reduction:the American Heart Association's Strategic Impact Goal through 2020 and beyond.Circulation,2010,121:586-613.
[14]杨伟宪,杨铮,窦克非,等.217例青年冠心病患者特点分析.中国循环杂志,2014,29:339-342.
[15]Williams CL,Hayman LL,Daniels SR,et al.Cardiovascular Health in Childhood A Statement for Health Professionals From the Committee on Atherosclerosis,Hypertension,and Obesity in the Young(AHOY)of the Council on Cardiovascular Disease in the Young,American Heart Association.Circulation,2002,106:143-160.
[16]Genest JJ,Mc Namara JR,Salem DN,et al.Prevalence of risk factors in men with premature coronary artery disease.Am J cardiol,1991,67:1185-1189.
[17]Giampaoli S,Palmieri L,Panico S,et al.Favorable cardiovascular risk profile(low risk)and 10-year stroke incidence in women and men:findings from 12 Italian population studies.Am J Epidemiol,2006,163:893-902.
[18]Neaton JD,Wentworth D.Serum Cholesterol,Blood Pressure,Cigarette Smoking,and Death From Coronary Heart Disease Overall Findings and Differences by Age for 316099 White Men.Arc intern med,1992,152:56.
[19]中国成人血脂异常防治指南制定联合委员会.中国成人血脂异常防治指南.中华心血管病杂志,2007,35:390-419.