期刊论文详细信息
Population Health Metrics
Trends and inequalities in short-term acute myocardial infarction case fatality in Scotland, 1988-2004
Research
Alastair H Leyland1  Carolyn A Davies1 
[1] MRC/CSO Social and Public Health Sciences Unit, MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, UK;
关键词: Acute Myocardial Infarction;    Case Fatality;    Socioeconomic Inequality;    Socioeconomic Deprivation;    Risk Factor Exposure;   
DOI  :  10.1186/1478-7954-8-33
 received in 2010-08-27, accepted in 2010-12-06,  发布年份 2010
来源: Springer
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【 摘 要 】

BackgroundThere have been substantial declines in ischemic heart disease in Scotland, partly due to decreases in acute myocardial infarction (AMI) incidence and case fatality (CF). Despite this, Scotland's IHD mortality rates are among the worst in Europe. We examine trends in socioeconomic inequalities in short-term CF after a first AMI event and their associations with age, sex, and geography.MethodsWe used linked hospital discharge and death records covering the Scottish population (5.1 million). Between 1988 and 2004, 178,781 of 372,349 patients with a first AMI died on the day of the event (Day0 CF) and 34,198 died within 28 days after surviving the day of their AMI (Day1-27 CF).ResultsAge-standardized Day0 CF at 30+ years decreased from 51% in 1988-90 to 41% in 2003-04. Day1-27 CF decreased from 29% to 18% over that period. Socioeconomic inequalities in Day0 CF existed for both sexes and persisted over time. The odds of case fatality for men aged 30-59 living in the most deprived areas in 2000-04 were 1.7 (95%CI: 1.3-2.2) times as high as in the least deprived areas and 1.9 (1.1-3.2) times as high for women. There was little evidence of socioeconomic inequality in Day1-27 CF in men or women. After adjustment for socioeconomic deprivation, significant geographic variation still remained for both CF definitions.ConclusionsA high proportion of AMI incidents in Scotland result in death on the day of the first event; many of these are sudden cardiac deaths. Short-term CF has improved, perhaps reflecting treatment advances and reductions in first AMI severity. However, persistent socioeconomic and geographic inequalities suggest these improvements are not uniform across all population groups, emphasizing the need for population-wide primary prevention.

【 授权许可】

CC BY   
© Davies and Leyland; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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