東臺灣中壯年男性急性心肌梗塞危險因子於1993-1999與2000-2006年間之差異探討

Risk Factors for Acute Myocardial Infarction Among Eastern Taiwan Middle-age Male between 1993-1999 and 2000-2006

本研究探討東台灣中壯年（＜65 歲）男性成年人急性心肌梗塞患者在冠狀動脈疾病的危險因子（冠危險因子）是否有年代別的變化趨勢。將1993 至2006 年間心導管檢查資料，以心導管檢查結果和時間做區隔，分成第一次急性心肌梗塞患者（ 急性心肌梗塞群）和正常冠狀動脈者（ 正常冠狀動脈群）兩大類，再以時間分成前期（1993-1999）與後期（2000-2006），探討的冠危險因子包括抽菸、糖尿病、高血壓、血清脂值、身體質量指數，以及總膽固醇／高密度脂蛋白膽固醇的動脈硬化指數。資料完整者共608 名，平均年齡 52.0±8.5 歲。急性心肌梗塞群292 名，其中前期70 名，後期222 名；正常冠狀動脈群316 名，其中前期66 名，後期250 名。群間顯著差異冠危險因子中，總膽固醇值主要出現於前期期間；高血壓與糖尿病比例二項，主要出現於後期期間；抽菸比例、高／低密度脂蛋白膽固醇值以及動脈硬化指數四項，則同時出現於前期與後期期間。1993 至2006 年間，不分前後期間別，抽菸與高／低密度脂蛋白膽固醇以及動脈硬化指數為東台灣中壯年男性成年急性心肌梗塞患者共同顯著冠危險因子。

This study aimed to compare coronary risk factors (CRFs) in Eastern Taiwan males between from 1993 to 1999 (pre) and from 2000 to 2006 (post) to understand the trends in CRFs in eastern Taiwan middle-age male. Subjects were compared between those who confirmed with angiographically patent coronary artery and those who suffered from the first time acute myocardial infarction. According to date that subjects had angiography procedure (pre vs. post) and the result of angiography (infarction vs. patent), CRFs in subjects were compared. CRFs include smoking, hypertension, diabetes, dyslipidemia, body mass index (BMI) and atherosclerosis index (AI). Only subjects with complete record in all CRFs were enrolled for analyses. A total of 608 subjects met the enroll criteria with mean age 52.0±8.5 years. Two hundreds and ninety-two subjects were in infarction group and within them 70 were in the pre subgroup and 222 were in the post subgroup. Three hundreds and sixteen were in patent group and within them 66 were in the pre subgroup and 250 were in the post subgroup. Major group difference was found in total cholesterol in pre period, and hypertension and diabetes were found in post period. Smoking, high/ low-density lipoprotein cholesterol and AI were significant different in both pre and post period. Smoking, high and low density lipoprotein cholesterol, and AI were mutual risk factors in eastern Taiwan middle-age males with AMI.