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Bráð kransæðaheilkenni á Landspítala á árunum 2003-2012

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Authors
Gestur Þorgeirsson
Birna Björg Másdóttir
Þórarinn Guðnason
María Heimisdóttir
Issue Date
2019-02

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Other Titles
Acute coronary syndromes in Landspítali 2003-2012
Citation
Bráð kransæðaheilkenni á Landspítala á árunum 2003-2012. 2019, 105(2): 79-84 Læknablaðið
Abstract
Inngangur: Á síðustu áratugum hafa orðið miklar breytingar á faraldsfræði kransæðasjúkdóms á Vesturlöndum. Með þessari rannsókn er kannað nýgengi bráðra kransæðaheilkenna á Landspítala árin 2003-2012. Efniviður og aðferðir: Allir sjúklingar með bráð kransæðaheilkenni innlagðir á Landspítala voru rannsakaðir á tímabilinu. Bráð kransæðaheilkenni eru hvikul hjartaöng, brátt hjartadrep án ST-hækkana (NSTEMI) og brátt hjartadrep með ST-hækkun (STEMI). Upplýsinga var aflað úr sjúkraskrám og gagnagrunnum Landspítala og breytingar á tímabilinu skoðaðar. Niðurstöður: Sjúklingar með bráð kransæðaheilkenni voru 7502. STEMI-tilfelli voru 98/100.000 íbúa árið 2003 en 63 árið 2012 sem er fækkun um tæp 36%. Leiðrétt fyrir aldri kom fram marktæk árleg lækkun (p<0,05) á nýgengi STEMI hjá körlum um 5,5% og konum 5,3%. Nýgengi NSTEMI var 54/100.000 íbúa árið 2003 en 93 árið 2012. Sjúklingar með hvikula hjartaöng voru 56/100.000 íbúa árið 2003, 115 árið 2008 og 50 árið 2012. Breytingar á tíðnitölum fyrir NSTEMI og hvikula hjartaöng voru ekki tölfræðilega marktækar. Konur voru um 35% sjúklinga með NSTEMI en um 30% sjúklinga með STEMI og hvikula hjartaöng. Meðalaldur NSTEMI-sjúklinga var 72 ár, um 5 árum hærri en sjúklinga með STEMI og hvikula hjartaöng. Um 30% bráðra kransæðatilfella komu af landsbyggðinni. Ályktun: Á árunum 2003-2012 varð 5% árleg tölfræðilega marktæk lækkun í nýgengi STEMI en á sama tíma var tilhneiging til aukningar á nýgengi NSTEMI, sem í lok tímabilsins var orðið algengasta heilkennið. Nýgengi hvikullar hjartaangar þróaðist með óvenjulegum hætti og er umhugsunarefni hvort andlegt álag í þjóðfélaginu á rannsóknartímabilinu hafi haft þar áhrif.
Background: Marked changes in the epidemiology of acute coronary syndromes (ACS) have been observed over the last few decades in the Western Hemisphere. Incidence rates of ACS in Iceland 2003-2012 are presented. Methods: All patients with unstable angina (UA), non ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarc­tion (STEMI) admitted to Landspitali were included in the study. Data were obtained from hospital records and changes during the period were examined. Results: The total number of ACS cases was 7,502. STEMI incidence was reduced from 98/100,000 inhabitants in 2003 to 63 in 2012, a reduction of nearly 36%. Age standardized incidence rates of STEMI declined annually by 5.5% in men and 5.3% in women (p <0.05). Incidence of NSTEMI increased from 54 /100,000 inhabitants in 2003 to 93 in 2012. UA patients were 56/100,000 inhabitants in 2003, 115 in 2008 and 50 in 2012. No significant annual change in age-standardized incidence rates of NSTEMI and UA was observed. About 35% of patients with NSTEMI and 30% with STEMI and UA were female. The mean age of NSTEMI patients was 72 years, five years higher than patients with STEMI and UA. About 30% of ­pat­ients were living outside of the capital region. Conclusions: 2003-2012 there was a significant 5% annual ­decrease in the number of STEMI cases and a tendency to ­increasing incidence of NSTEMI which by the end of the research period was the most common of the syndromes. An unusual development in the incidence of UA was observed. Possible effect of psychological stress in the society should be considered.
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https://www.laeknabladid.is/tolublod/2019/02/nr/6963
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Icelandic Journal Articles (Peer Reviewed)

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