目的:同时重新评估发病率,患病率,和奥姆斯特德县肥厚型心肌病(HCM)的自然史,明尼苏达,从1984年到2015年。
方法:在1984年1月1日至2015年12月31日期间,使用了一个为奥姆斯特德县居民收集信息的有效医疗记录链接系统来识别所有HCM病例。在裁定梅奥诊所和奥姆斯特德医疗中心的记录后,我们提取了与诊断和结局相关的数据.将计算的发病率和患病率标准化为美国1980年白人人口(年龄和性别调整),并与先前研究1975-1984年的研究进行了比较。
结果:确定了二百七十名患有HCM的受试者。年龄和性别调整后的发病率为6.6/10万人年,2016年1月1日的HCM点患病率为每100,000人中89人。2016年1月1日HCM的发病率和点患病率,标准化为美国1980年白人人口(年龄和性别调整),每100,000人年为6.7(95%CI,7.1至8.8),每100,000人口为81.5,分别。自指数研究以来,HCM的发病率每十年都在增加。HCM患者的总体标准化死亡率高于普通人群,观察到的预期HR为1.44(95%CI,1.21至1.71;P<.001),每十年改善一次。
结论:HCM的发病率和患病率高于先前在同一社区研究1975-1984年报告的发病率,但低于其他研究队列。HCM的死亡风险仍然高于预期,尽管在研究期间每十年观察到死亡率的改善。
OBJECTIVE: To contemporaneously reappraise the incidence-rate, prevalence, and natural history of hypertrophic cardiomyopathy (HCM) in Olmsted County, Minnesota, from 1984 to 2015.
METHODS: A validated medical-record linkage system collecting information for residents of Olmsted County was used to identify all cases of HCM between January 1, 1984, and December 31, 2015. After adjudication of records from Mayo Clinic and Olmsted Medical Center, data relating to diagnoses and outcomes were abstracted. The calculated incidence rate and prevalence were standardized to the US 1980 White population (age- and sex-adjusted) and compared with a prior
study examining the years 1975-1984.
RESULTS: Two hundred seventy subjects with HCM were identified. The age- and sex-adjusted incidence rate was 6.6 per 100,000 person-years, and the point prevalence of HCM on January 1, 2016, was 89 per 100,000 population. The incidence rate and point prevalence of HCM on January 1, 2016, standardized to the US 1980 White population (age- and sex-adjusted), were 6.7 (95% CI, 7.1 to 8.8) per 100,000 person-years and 81.5 per 100,000 population, respectively. The incidence rate of HCM increased each decade since the index
study. Individuals with HCM had a higher overall standardized mortality rate than the general population with an observed to expected HR of 1.44 (95% CI, 1.21 to 1.71; P<.001) which improved by each decade.
CONCLUSIONS: The incidence and prevalence of HCM are higher than rates reported from a prior
study in the same community examining the years 1975-1984, but lower than other
study cohorts. The risk of mortality in HCM remains higher than expected, albeit with improvement in rates of mortality observed each decade during the
study period.