Epidemiologia de l'infart agut de miocardi en la població major de 60 anys de l'àrea de Tarragona: estudi de cohorts de base poblacional.

Identificador:  TDX:3354

Handle: https://hdl.handle.net/20.500.11797/TDX3354

Autors:  Forcadell Peris, María José

Resum:
Acute myocardial infarction (AMI) is one of the main causes of morbimortality in the Spanish population. Population-based data about the epidemiology of AMI is limited. The present thesis aimed to analyzed the epidemiology of AMI (incidence, mortality and specific underlying chronic conditions). We investigated a large population-based cohort that included all individuals older than 60 years assigned to 9 Primary Care Centres in the region of Tarragona (n=27,204). All hospitalised AMI cases occurred among cohort members during 3 years, where included. We estimated incidence rates, mortality and confidence intervals (CI) at 95%. Cox regression models were used to calculate Hazards Ratios and estimated the association between baseline conditions and the risk of developing AMI. The global AMI incidence was 475 per 100,000 person-years (CI 95%:428-527), and it was more than double in men (681 per 100,000) than women (311 per 100,000) (p<0.001). By age groups incidence was 277 in 60-69 years, 632 in 70-79 years and 690 per 100,000 person-year in 80 or more years (p<0.001). Maximum rates appeared among individuals with history of coronary artery disease (2,839 per 100,000). Thirty-day mortality after diagnosis was 15.3%. In the multivariable analysis, history of coronary artery disease, male sex, chronic heart disease, diabetes mellitus, older than 70 years, history of stroke, atrial fibrillation and hypertension emerged as significantly associated with an increased risk of AMI. Our data shows that incidence and mortality of AMI remains considerable among people over 60 years in our setting, being especially high among the oldest people. Considering classical major risk factors, diabetes mellitus and hypertension were the underlying conditions most strongly associated with an increased risk of developing AMI in our study cohort.