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.
目的： 分析2007－2012年北京市急性心肌梗死（AMI）住院患者30 d内因冠心病死亡比例的人群分布特征及时间变化趋势。 方法： 从"北京市心血管病监测系统"中获取2007年1月1日至2012年12月31日主要出院诊断为AMI的病例，经过户籍地址整理、重报病例排查、数据完整性和准确性审核后，纳入≥25岁北京市户籍AMI住院患者77 943例。分析其临床特征和30 d内因冠心病死亡的数据，并采用泊松回归模型分析病死率变化趋势。 结果： 77 943例患者30 d内归因于冠心病的年龄标化病死率为9.7%；调整年龄和性别后，病死率随时间呈下降趋势（P<0.001），6年间从10.8%降至9.0%，下降了16.0%。调整年龄后，女性患者30 d病死率（14.1%）高于男性（7.6%），男女性病死率均呈下降趋势。6年间ST段抬高型心肌梗死（STEMI）患者的构成比逐年下降（P<0.001），而非STEMI患者的构成比逐年上升（P<0.001），30 d冠心病年龄标化病死率前者下降了20.1%（P<0.001），而后者未见明显改善。 结论： 2007－2012年北京市≥25岁AMI住院患者30 d内因冠心病病死率呈持续下降趋势，说明AMI患者的短期预后有所改善，但女性患者和非STEMI患者的治疗仍有待加强。.
Keywords: Acute myocardial infarction; Hospitalization; Mortality.