IMIM - Institut Hospital del Mar d'Investigacions Mèdiques

Agenda

29 d'octubre de 2014

Tendències de la magnitud de la cardiopatia isquèmica a Europa

Sala Xipre (173.06-1a planta IMIM) a les 15:00 hores

En el marc de les sessions d'Epidemiologia i Salut Pública de l'IMIM, el proper dia 29 d'octubre a les 15:00 h tindrà lloc la sessió "Tendències de la magnitud de la cardiopatia isquèmica a Europa" a càrrec del Dr. Jaume Marrugat, coordinador del grup de recerca en epidemiologia i genética cardiovascular de l'IMIM. La sessió tindrà lloc a la Sala Xipre (173.06-1a planta de l'IMIM).

Veure pòster.

Resum en anglès

Acute coronary syndrome (ACS) is the single most common cause of death in Europe, accounting for 1.8 million deaths yearly. Costs related to all coronary heart diseases (CHD) exceed €60 billion annually in the EU.

According to data from the most updated population and hospital registries, more than 115,500 ACS cases occurred in Spain in 2013, with an estimated 28-day mortality of 39,086 and hospitalization of 85,326 patients. Based on recent trends, non-ST segment elevation ACS cases (56%) and acute myocardial infarction (AMI) (81%) are expected to be the most common admission and discharge diagnoses, respectively. Approximately 109,772 ACS cases are anticipated in 2021. The ACS trend from 2005 to 2049 is expected to stabilize in the population aged 25 to 74 years but increase in those older than 74 years owing to population aging.

From 1985 to 2010, rates of AMI and case-fatality significantly decreased by sex and all age groups in 6 European regions with continued AMI population registries. Over the last 30 years, CHD mortality rates have been decreasing in Europe but have been more likely to plateau in younger people than in older age groups. There are, however, substantial and persistent inequalities between countries.

Differences between Northern, Central, Western, Eastern and Southern European countries in CHD mortality were initially described in the 20th century, and albeit less dramatic than first reported, these differences remain substantial. Four main hypotheses have been proposed to explain the so-called ‘‘Mediterranean paradox’’: a) underestimation of coronary heart disease mortality due to methodological flaws; b) the ‘‘lag time’’ hypothesis, c) the traditional Mediterranean diet and lifestyle, and d) a possible higher prevalence and incidence of stable atheromatous plaques in the Mediterranean population.

The widespread use of CHD risk algorithms has transformed clinical decision-making in CHD prevention. A new challenge in this CHD preventive field that could refine the policy decisions includes the 10-year projections obtained with CHD risk functions used to test the population effects of risk factor prevalence modification on future CHD incidence. The CASSANDRA project (www.redheracles.net/cassandra/es) has shed some light on this approach in Spain and the ongoing EUROTRACS European project will contribute to disseminate this tool in another 5 European countries.

Key References

  • Nichols M, EHJ. 2013; 34: 3017–27.
  • Degano IR. REC (English Edition). 2013; 66: 472-81
  • Degano IR. REC (English Edition). 2013;66:56–62.
  • Manuel DG. JECH. 2012; 66: 859-65.
  • Grau M. JECH 2014. doi:10.1136/jech-2013-203516.

Tots els actes

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