WHO programs "Acute Myocardial Infarction Register", MONICA: thirty years (1977-2006) of epidemiological studies of myocardial infarction in a high-risk population

Abstract

Aim. To reveal 30 year (1977-2006) trends of myocardial infarction (MI) morbidity, lethality and mortality in population of the West Siberia megapolis (Novosibirsk). Material and Methods. WHO programs "Acute Myocardial Infarction Register (AMIR) and MONICA covered 3 districts of Novosibirsk. Results. MI morbidity in 25-64 year old population of Novosibirsk (high-risk population) in Russia is one of the highest in the world. MI morbidity was stable for 30 years excluding in 1988, 1994 and 1998 when it rose and in 2002-2004, 2006 when it lowered. Changes in mortality and lethality resemble changes in morbidity trend excluding 1977-1978 (fall) and 2002-2005 (rise). Prehospital mortality and lethality were much higher than those in hospital. Mortality and lethality in 1988, 1994, 1998 and 2002-2005 increased due to prehospital lethality and mortality, while it decreased in 1977-1978 due to hospital one. Reduction of mortality and lethality in stable MI morbidity shows improvement of medical care for MI patients, increased lethality and mortality in MI morbidity decline reflect deterioration of such care. Changes in behavioral and somatic factors of cardiovascular risk in population of Novosibirsk for 30 years were not observed while psychosocial risk factors gain a significant importance. By indirect indications, MI morbidity, mortality and lethality mark growing social stress in the population. MI mortality is 2-3 times higher than that of alcohol and is a basic factor of mortality increase in the population of Russia. Conclusion. MI morbidity, mortality and lethality are markers of social stress in population.

Keywords

• "monica"
• acute myocardial infarction register
• monica epidemiological trials
• myocardial infarction
• high