心肌梗死与身体功能:卒中中地理和种族差异的REasons前瞻性队列研究。

BMJ public health Pub Date : 2023-01-01 Epub Date: 2023-10-12 DOI:10.1136/bmjph-2023-000107
Emily B Levitan, Parag Goyal, Joanna Bryan Ringel, Orysya Soroka, Madeline R Sterling, Raegan W Durant, Todd M Brown, C Barrett Bowling, Monika M Safford
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引用次数: 0

摘要

目的:探讨心肌梗死(MI)与多种生理功能指标之间的关系。方法:在脑卒中地理和种族差异REasons前瞻性队列研究中,年龄≥45岁的参与者中,在大约10年的随访后,对日常生活工具活动(IADL)、日常生活活动(ADL)、步态速度、椅子站立和简式12身体成分总结(PCS)进行评估。我们研究了心肌梗死与身体功能之间的关系(无心肌梗死[n=9472],随访期间判定的心肌梗死[n=288,功能评估前中值4.7年],基线时心肌梗死史[n=745],基线心肌梗死史和随访期间判定心肌梗死[n=70,功能评估后中值6.7年])。模型根据社会人口统计学特征、健康行为、抑郁症状、认知障碍、体重指数、糖尿病、高血压和尿白蛋白与肌酐的比值进行了调整。我们研究了按年龄、性别和种族定义的亚组。结果:基线时的平均年龄为62岁,56%为女性,35%为黑人。MI与较差的IADL和ADL评分、IADL依赖性、椅子站立和PCS显著相关,但与ADL依赖性或步态速度无关。例如,与无MI的参与者相比,随访期间患有MI的参与者的IADL得分(可能在0-14之间,得分越高表示功能越差)越高(差异:0.37[95%CI 0.16,0.59]),基线时的MI得分(0.26[95%CI 0.12,0.41]),基线和随访时的MI分(0.71[95%CI 0.15,1.26]),p<0.001。女性,尤其是黑人女性参与者之间的关联往往更大。结论:MI与多种生理功能指标有关。这些与心肌梗死相关的功能下降可能是可以预防或治疗的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Myocardial infarction and physical function: the REasons for Geographic And Racial Differences in Stroke prospective cohort study.

Objective: To examine associations between myocardial infarction (MI) and multiple physical function metrics.

Methods: Among participants aged ≥45 years in the REasons for Geographic And Racial Differences in Stroke prospective cohort study, instrumental activities of daily living (IADL), activities of daily living (ADL), gait speed, chair stands, and Short Form-12 physical component summary (PCS) were assessed after approximately 10 years of follow-up. We examined associations between MI and physical function (no MI [n = 9,472], adjudicated MI during follow-up [n = 288, median 4.7 years prior to function assessment], history of MI at baseline [n = 745], history of MI at baseline and adjudicated MI during follow-up [n = 70, median of 6.7 years prior to function assessment]). Models were adjusted for sociodemographic characteristics, health behaviours, depressive symptoms, cognitive impairment, body mass index, diabetes, hypertension, and urinary albumin to creatinine ratio. We examined subgroups defined by age, gender, and race.

Results: The average age at baseline was 62 years old, 56% were women, and 35% Black. MI was significantly associated with worse IADL and ADL scores, IADL dependency, chair stands, and PCS, but not ADL dependency or gait speed. For example, compared to participants without MI, IADL scores (possible range 0-14, higher score represents worse function) were greater for participants with MI during follow-up (difference: 0.37 [95% CI 0.16, 0.59]), MI at baseline (0.26 [95% CI 0.12, 0.41]), and MI at baseline and follow-up (0.71 [95% CI 0.15, 1.26]), p < 0.001. Associations tended to be greater in magnitude among participants who were women and particularly Black women.

Conclusion: MI was associated with various measures of physical function. These decrements in function associated with MI may be preventable or treatable.

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