Paternal and Maternal History of Myocardial Infarction and Cardiovascular Diseases Incidence in a Dutch Cohort of Middle-Aged Persons

Background - A positive parental history of myocardial infarction (MI) is an independent risk factor for cardiovascular diseases (CVD). However, different definitions of parental history have been used. We evaluated the impact of parental gender and age of onset of MI on CVD incidence. Methods - Baseline data were collected between 1993 and 1997 in 10¿524 respondents aged 40–65 years. CVD events were obtained from the National Hospital Discharge Register and Statistics Netherlands. We used proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (CI) for CVD incidence and adjusted for lifestyle and biological risk factors. Results - At baseline, 36% had a parental history of MI. During 10-year follow-up, 914 CVD events occurred. The age and gender adjusted HR was 1.3 (95% CI 1.1–1.5) for those with a paternal MI, 1.5 (1.2–1.8) for those with a maternal MI and 1.6 (1.2–2.2) for those with both parents with an MI. With decreasing parental age of MI, HR increased from 1.2 (1.0–1.6) for age =70 years to 1.5 (1.2–1.8) for ag

2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).

European Society of CardiologyThis is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/eurheartj/ehw10

Coronaire hartziekten, steeds later en vaker chronisch

Background To identify ageand genderspecific trends in hospital admissions due to acute myocardial infarction, unstable angina and chronic coronary heart disease in the Netherlands between 1998 and 2007. Design Recordlinkage cohort study. Method By linking data from the population register to the national hospital register we determined for the years 1998 and 2007 the incidence of hospitalization rates with acute myocardial infarction (ICD9 410), unstable angina (411, 413) or chronic coronary heart disease (412, 414) as primary diagnosis. We analyzed a total of 136,568 hospital admissions, 36,804 of which were due to acute myocardial infarction, 58,475 due to unstable angina and 41,289 due to chronic coronary heart disease. Results The proportion of unstable angina remained the same between 1998 and 2007 at 40% in men and 50% in women, while chronic coronary heart disease rose from 29% to 36% in men and from 23% to 30% in women and acute myocardial infarction declined from 30% to 24% in men and from 27% to 22% in women. The average age at admission was higher in 2007 than in 1998, and we saw a decline in admission rates in younger age categories as compared to an increase in older age categories. For chronic coronary heart disease, this turning point was at 65 years of age, for unstable angina at 75 years of age and for acute myocardial infarction at 95 years of age. Conclusion Between 1998 and 2007, two shifts in hospital admissions occurred due to coronary heart disease in the Netherlands. Firstly, an increasing proportion was for chronic forms of coronary heart disease, and secondly, the average age of admitted patients increased. Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article

Shifts in the age distribution and from acute to chronic coronary heart disease hospitalizations

Background Shifts in the burden of coronary heart disease (CHD) from an acute to chronic illness have important public health consequences. Objective To assess age-sex-specific time trends in rates and characteristics of acute and chronic forms of CHD hospital admissions in the Netherlands. Methods Using nationwide Dutch registers, we assessed time trends between 1998 and 2007 in hospitalization rates of 188,266 acute myocardial infarction (AMI, ICD-9 410), 294,374 unstable angina (ICD-9 411, 413) and 205,649 chronic forms of CHD (ICD-9 412, 414) admissions. Results Between 1998 and 2007, the age-standardized CHD hospitalization rate declined from 688 to 545 per 100,000 in men and from 281 to 229 per 100,000 in women. Overall, hospitalization rates decreased at younger age

The dynamics of mortality in follow-up time after an acute myocardial infarction, lower extremity arterial disease and ischemic stroke

Abstract Background Most studies providing data on survival in patients with atherosclerosis only address a single disease site: heart, brain or legs. Therefore, our objective was to determine risk of death after first hospital admission for atherosclerotic disease located at different sites. Methods A nationwide cohort of patients hospitalized for the first time for acute myocardial infarction (AMI), peripheral arterial disease of the lower extremities (PAD) or ischemic stroke was identified through linkage of national registers. The mortality rate in AMI patients was compared to mortality rate in ischemic stroke and PAD patients by estimating relative risks (with 95%CI). Cox's proportional hazard models were used to estimate sex differences in risk of death. Results Case fatality was high for ischemic stroke patients (men:21.0%, women:23.8%) and AMI patients (men:12.7%, women:20.9%) though low for PAD patients (men:2.4%, women:3.5%). The five-year risk of death was similar for male AMI compared to PAD patients (men: RR1.04; 95%CI 0.98-1.11). The risk of death for ischemic stroke patients remained the highest though the differences with AMI and PAD patients attenuated. Conclusions The dynamics of mortality over follow-up time clearly differ between atherosclerotic diseases, located at different vascular beds. The risk of death increases considerably over follow-up time for PAD patients, and 5 years after first hospital admission the differences in risks of death between AMI- and PAD patients and between AMI- and ischemic stroke patients have largely attenuated. Clinicians should be aware of these dynamics of mortality over follow-up time to provide optimal secondary prevention treatment.</p

Trends in comorbidity in patients hospitalised for cardiovascular disease

Background: We determined trends over time in cardiovascular and non-cardiovascular comorbidity in patients hospitalised for cardiovascular disease (CVD).  Methods: The Dutch nationwide hospital register was used to identify patients hospitalised for CVD during 2000-2010. Comorbidity was defined as a previous hospital admission for CVD other than the index CVD, cancer, diabetes, musculoskeletal and connective tissue disorders, respiratory disorders, thyroid gland disorders, kidney disorders and dementia in the five years previous to hospital admittance for the index CVD. Trends were calculated in strata of age and sex and for different types of CVD: coronary heart disease (CHD), cerebrovascular disease (CVA), heart failure (HF) and peripheral arterial disease (PAD).  Results: We identified 2,397,773 admissions for CVD between 2000 and 2010. Comorbidity was present in 38%. In HF, PAD, CHD and CVA this was 54%, 46%, 40%, and 32%, respectively. Between 2000 and 2010, the percentage of patients with comorbidity increased (+. 1.1%), this increase was most pronounced in patients ≥. 75. years (+. 3.0%). Cardiovascular disease was the most frequent comorbid condition, though became less prevalent over time (men -5%; women: -2%), whereas non-cardiovascular comorbidity increased in men (+. 4%), and remained similar in women (-1%). Cancer was the most common non-cardiovascular comorbid condition and increased in men and women (men: +. 5%; women: +. 4%).  Conclusions: Comorbid conditions are highly prevalent in patients hospitalised for CVD, especially HF and PAD patients. In older patients, prevalences increased over time. Cardiovascular diseases were the most common comorbid condition, though the prevalence decreased over the study period whereas the prevalence of cancer increased