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Objective To understand the distribution and trends in 30-day coronary heart disease (CHD) case fatality rate in patients hospitalized due to acute myocardial infarction (AMI) in Beijing during 2007-2012.Methods The clinical data of patients hospitalized due to AMI in Beijing from 1 January 2007 to 31 December 2012 were collected from "The Cardiovascular Disease Surveillance System in Beijing".A total of 77 943 local patients aged ≥25 years were hospitalized due to AMI in Beijing during the this period.After excluding duplicate records and validation for the completeness and accuracy of the records,the clinical characteristics of the patients and 30-day CHD case fatality rate in the patients were analyzed.Trends in 30-day CHD case fatality rate in the patients were analyzed with Poisson regression models.Results The age-standardized average 30-day CHD case fatality rate was 9.7％ in the 77 943 patients.During this period,a decreasing trend was observed in 30-day CHD case fatality rate after adjusting for age and gender (P＜0.001).The age-standardized 30-day CHD case fatality rate decreased by 16.0％,from 10.8％ in 2007 to 9.0％ in 2012.The decreases of 30-day CHD case fatality rates were noted in both men and women,whereas 30-day CHD case fatality rate was higher in women (14.1％) than in men (7.6％) after adjusting for age.During this period,the proportion of ST-segment elevation myocardial infarction (STEMI) decreased,while the proportion of non-ST-segment elevation myocardial infarction (NSTEMI) increased with year.A significant decline (20.1％) in 30-day case fatality rate of STEMI was found,but no decline was found for 30-day mortality rate of NSTEMI.Conclusion A decreasing trend in 30-day CHD case fatality rate was observed in the patients aged ≥25 years and hospitalized due to AMI in Beijing during 2007-2012,indicating the improvement in short-term prognosis of patients hospitalized due to AMI.Our findings highlight the urgent need to improve the treatment for woman and NSTEMI patients.
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Objective To understand the distribution and trends in 30-day coronary heart disease (CHD) case fatality rate in patients hospitalized due to acute myocardial infarction (AMI) in Beijing during 2007-2012.Methods The clinical data of patients hospitalized due to AMI in Beijing from 1 January 2007 to 31 December 2012 were collected from "The Cardiovascular Disease Surveillance System in Beijing".A total of 77 943 local patients aged ≥25 years were hospitalized due to AMI in Beijing during the this period.After excluding duplicate records and validation for the completeness and accuracy of the records,the clinical characteristics of the patients and 30-day CHD case fatality rate in the patients were analyzed.Trends in 30-day CHD case fatality rate in the patients were analyzed with Poisson regression models.Results The age-standardized average 30-day CHD case fatality rate was 9.7％ in the 77 943 patients.During this period,a decreasing trend was observed in 30-day CHD case fatality rate after adjusting for age and gender (P＜0.001).The age-standardized 30-day CHD case fatality rate decreased by 16.0％,from 10.8％ in 2007 to 9.0％ in 2012.The decreases of 30-day CHD case fatality rates were noted in both men and women,whereas 30-day CHD case fatality rate was higher in women (14.1％) than in men (7.6％) after adjusting for age.During this period,the proportion of ST-segment elevation myocardial infarction (STEMI) decreased,while the proportion of non-ST-segment elevation myocardial infarction (NSTEMI) increased with year.A significant decline (20.1％) in 30-day case fatality rate of STEMI was found,but no decline was found for 30-day mortality rate of NSTEMI.Conclusion A decreasing trend in 30-day CHD case fatality rate was observed in the patients aged ≥25 years and hospitalized due to AMI in Beijing during 2007-2012,indicating the improvement in short-term prognosis of patients hospitalized due to AMI.Our findings highlight the urgent need to improve the treatment for woman and NSTEMI patients.
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Objective@#To explore the association between long-term changes in blood pressure (BP) levels and the incidence of cardiovascular diseases (CVD).@*Methods@#A total of 5 752 participants, who participated baseline examination in 1992-1993 and re-examination in 2007, were followed up till December 31, 2013 according to the study protocol of the Chinese Multi-provincial Cohort Study. Participants were stratified by baseline BP and re-examination BP and cross-combined into 9 subgroups. The 20-year incidence of acute cardiovascular events, acute coronary heart disease (CHD) and acute stroke events were analyzed and association between disease incidence and 15-year changes in BP were determined using the competing risk regression model.@*Results@#(1) There were 523 CVD events (170 CHD, 373 stroke) during the 20 years follow up. The number of participants with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) of <130/80 mmHg (1 mmHg=0.133 kPa), 130-139/80-89 mmHg, and hypertension were 2 892 (50.3%), 1 328 (23.1%) and 1 532 (26.6%), respectively. (2) Among participants with baseline SBP of 130-139 mmHg or DBP of 80-89 mmHg, 870 (65.5%) progressed to hypertension and 279 (21.0%) maintained at the same stratum over a 15-year follow up period. (3) After adjustment for age, sex, body mass index, smoking status, diabetes, total cholesterol, and high-density lipoprotein cholesterol at baseline, participants maintained SBP/DBP at 130-139/80-89 mmHg had a higher risk of developing acute cardiovascular events, CHD and stroke with the hazard ratios (HR) and 95% confidence interval (95%CI) of 2.04 (1.16, 3.57), 3.29 (1.30, 8.35) and 1.63 (0.80, 3.33), compared with those who maintained their SBP < 130 mmHg and DBP <80 mmHg. Participants whose BP increased from 130-139/80-89 mmHg to hypertension over the follow up period had 2.81-fold (1.84, 4.29), 3.17-fold (1.43, 7.03) and 2.71-fold (1.65, 4.44) higher risk for the incidence of acute cardiovascular events, CHD, and stroke, respectively, compared with participants who maintained their SBP <130 mmHg and DBP <80 mmHg.@*Conclusions@#Participants with SBP/DBP of 130-139/80-89 mmHg have a high long-term risk for progression to hypertension. Sustained exposure to SBP/DBP of 130-139/80-89 mmHg or higher increases the risk of CVD incidence, and our results highlight the importance of early prevention for participants with this BP stratum.