Objective: To explore the trends change in mortality following acute myocardial infarction (AMI) from 1999 to 2015 in Tianjin, China. Methods: AMI mortality data from 1999 to 2015 were obtained from Tianjin population based mortality surveillance system operated by the Tianjin Centers for Disease Control and Prevention (CDC), and population data of permanent residents were obtained from Tianjin Municipal Public Security Bureau. The trends change and affecting factors including gender, age, and geographic distribution on mortality following AMI were analyzed. Results: (1)The standardized mortality rate of AMI in Tianjin from 1999 to 2015 was 52.32/100 000 to 48.62/100 000. Adjusted AMI mortality rate from 1999 to 2013 was 52.32/100 000 to 73.72/100 000, indicating an increased trend(Z=32.15, P<0.001)with an annual percent change (APC) of 2.53%. Adjusted AMI mortality rate was decreased from 2013 to 2015: 73.72/100 000 to 48.62/100 000 (Z=-22.80, P<0.001), and APC was -19.07%. Above trends change was similar for male and female residents (all P<0.001). (2)The AMI standardized mortality rate of male was significantly higher than that of female during the 17 years. The AMI standardized mortality of male was significantly higher than that of female in<35, 35-44, 45-54, 55-64 and ≥65 years old group, respectively. AMI mortality rate increased with age. (3)Except in the year of 2002 and 2003, the AMI mortality rate were significantly higher in rural residents than in urban residents during this study period (P<0.001). Adjusted AMI mortality in urban residents increased from 1999 to 2009(Z=8.05, P<0.001, APC=1.43%), and decreased in the year from 2009 to 2015 (Z=-18.71, P<0.001, APC=-6.32%). Adjusted AMI mortality in rural residents increased in the year of 1999 to 2013(Z=56.05, P<0.001, APC=5.84%), and decreased in the year of 2013 to 2015 (Z=-24.40, P<0.001, APC=-21.35%). Conclusions: Our results suggest that AMI mortality in Tianjin increased from 1999 to 2013, and decreased from 2013 to 2015, and male and rural residents have higher AMI mortality. Related prevention and intervention measures should be taken to decrease AMI mortality, especially for male and rural residents.
目的： 了解1999至2015年天津市居民急性心肌梗死(AMI)死亡率及变化趋势。 方法： 采用天津市疾病预防控制中心收集的居民全死因监测数据，统计天津市居民1999至2015年的AMI死亡率。天津市户籍人口信息来源于天津市公安局。分析AMI死亡率在1999至2015年的变化趋势以及在不同性别、年龄以及城乡之间分布的差异。 结果： (1)1999至2015年天津市AMI年龄标化死亡率为52.32/10万～48.62/10万。AMI标化死亡率1999至2013年为52.32/10万～73.72/10万，呈逐年上升趋势(Z＝32.15，P<0.001)，年度变化百分比(APC)为2.53%; AMI标化死亡率2013至2015年为73.72/10万～48.62/10万，呈逐年下降趋势(Z＝－22.80，P<0.001)，APC为－19.07%。男性和女性居民AMI死亡率的阶段性变化特点与总标化死亡率一致(P均<0.001)。(2)17年间男性AMI标化死亡率总体高于女性；在<35、35～44、45～54、55～64和≥65岁年龄组中，男性AMI标化死亡率也均高于女性。随着年龄增大，AMI死亡率逐渐升高。(3)除了2002和2003年，城市其余年份标化死亡率均低于农村(P<0.001)。城市AMI标化死亡率1999至2009年呈上升趋势(Z＝8.05，P<0.001)，APC为1.43%；城市AMI标化死亡率2009至2015年呈下降趋势(Z＝－18.71，P<0.001)，APC为－6.32%。农村标化死亡率1999至2013年呈上升趋势(Z＝56.05，P<0.001)，APC为5.84%；农村标化死亡率2013至2015年呈下降趋势(Z＝－24.40，P<0.001)，APC为－21.35%。 结论： 1999至2015年天津市居民AMI死亡率呈1999至2013年上升和2013至2015年下降的特点，男性和农村人群为AMI死亡高发人群。应采取有针对性的预防和干预措施，降低急性心肌梗死的死亡率。.
Keywords: Epidemiologic studies; Mortality; Myocardial infarction.