Natural history of acute coronary heart attacks. A community study.

作者：A Armstrong, B. McL. Duncan, M.F. Oliver, Desmond G. Julian, Kenneth W. Donald, Mary Fulton, Wolfgang Lutz, S L Morrison · 发表于：Heart · 年份：1972 · DOI：10.1136/hrt.34.1.67 · 被引用次数：215 · 研究领域：Cardiac Arrest and Resuscitation、Cardiovascular Effects of Exercise、Mechanical Circulatory Support Devices

Over a one-year period, i858 episodes of suspected acute heart attack occurring in the Edinburgh population under the age of 70 were documentedfrom a notification survey conducted by a special team in liaison with general practitioners, hospitals, and police surgeons.The overall annual incidence of episodes of acute heart attack in the population aged 40 to 69 years was v_ per cent for men and o 5 per cent for women: for first attacks it was 0 7 per cent for men and 0 -2 per cent for women.The high early death rate outside hospital is emphasized.Of all deaths occurring within the first 4 weeks, 73 per cent took place outside hospital and 45 per cent occurred within one hour of the onset of the acute attack.In men 23 per cent and in women 28 per cent offirst attacks presented as medically unattended deaths.Data are presented comparing mortality at home and in hospital, and the difficulties of making valid comparisons are stressed.General practitioners selected with a high level of accuracy the group with the largest proportion of myocardial infarction for hospital care.For patients referred to hospital, the median time from the onset of the acute attack to sending for medical aid was I hour 30 minutes and to arrival in hospital was 5 hours 23 minutes.A detailed account of these delays is given.While epidemiological studies have made a major contribution to knowledge about some of the causes of coronary heart disease, the natural history of acute heart attacks is still obscure....