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| 1 | 基于社区的心肌梗死后卒中发病率研究显示文摘Background: The rate of stroke after myocardial infarction(MI) remains unclear. Objectives: To examine the rate of stroke after incident MI; compare it with that observed in the population of Rochester, Minnesota; determine how the rate of stroke after MI has changed over time; and examine the impact of stroke on survival after incident MI. Design: Community-based cohort. Setting: Olmsted County, Minnesota. Participants: Persons with incident(first-ever) MI between 1979 and 1998. Measurements: Ischemic or hemorrhagic stroke in hospitalized and non-hospitalized patients that was identified by screening of the medical record for stroke diagnostic codes and subsequent stroke confirmation by physician review of the recorded event. Medical record review was used to ascertain baseline characteristics and death. Results: A total of 2160 persons with incident MI were hospitalized between 1979 and 1998 and followed for a median of 5.6 years(range, 0 to 22.2 years). The rate of stroke was 22.6 per 1000 person-months(95% CI, 16.3 to 30.6 per 1000 person-months) during the first 30 days after MI, corresponding to a 44-fold increase(standardized morbidity ratio, 44[95% CI, 32 to 59]) risk for stroke in the population of Rochester, Minnesota. The risk for stroke remained 2 to 3 times higher than expected during the first 3 years after MI. Older age, previous stroke, and diabetes increased the risk for stroke, which did not decline over the study period. Strokes were associated with a large increase in the risk for death after MI(hazard ratio, 2.89[CI, 2.44 to 3.43]). Limitations: Findings may not be generalizable to different populations. The authors measured outcomes by reviewing medical records. Conclusions: In the community, the risk for stroke is markedly increased after MI, particularly early after MI, compared with the expected risk in population without MI. Stroke is associated with a large increase in the risk for death after MI. | Witt B.J Brown Jr. R.D Jacobsen S.J. V.L.Roger 任付先 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，2，5： | 0 |
| 2 | 急性心肌梗死后室性心律失常:一项20年的社区研究显示文摘Background: Although myocardial infarction(MI) severity is declining, the occurrence of ventricular arrhythmia(VA) after MI and its effect on outcome is unknown. This study was undertaken to examine the frequency and timing of VA and the effect of VA on mortality after MI. Methods: Myocardial infarctions recorded between 1979 and 1998 were validated. Baseline characteristics, occurrence of VA, and survival were determined. Ventricular arrhythmias were categorized as primary ventricular fibrillation(VF), nonprimary VF, and ventricular tachycardia(VT). Logistic regression was used to analyze associations between VA and baseline characteristics. Temporal trends were assessed with the Mantel-Haenszel χ2. Survival was analyzed with the Kaplan-Meier method. Proportional hazards regression was used to examine the association between death and occurrence of VA. Results: Among 2317 persons with incident MI, 7.5%experienced VA(3.6%nonprimary VF, 2.1%primary VF, 1.8%VT). Ventricular arrhythmia-associated factors were younger age, female sex, higher Killip class, ST elevation, and atrial fibrillation. Ventricular arrhythmias were associated with increased risk of death at 30 days. Conclusions: Ventricular arrhythmias after MI are relatively common, particularly among persons with more severe MI and no prior history of coronary disease. Over time, the incidence of VF declined, whereas VT did not change. Ventricular arrhythmia after MI was associated with a 6-fold increase in morality. Thus, identification of highrisk MI survivors and prevention of VA could markedly improve outcomes. Further studies are needed to determine the cause of the shift in distribution of VA subtype. | Henkel D.M. Witt B.J. Gersh B.J. V.L.Roger 刘少伟 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，2，9： | 0 |
| 3 | 社区中的收缩性和舒张性心力衰竭 | Bursi F. Weston S.A. Redfield M.M. V.L.Roger 马超 | 2007 | 世界核心医学期刊文摘(心脏病学分册)2007，0，4： | 0 |
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