Archives of Hellenic Medicine

Last update:

16-Jun-2006

Arch Hellen Med, 22(6), November-December 2005, 575-580

ORIGINAL PAPER

An epidemiological study of ischemic heart disease (IHD) in northwestern Greece

A. PAPATHANASIOU,¹ K. PAPPAS,¹ I. LEONTARIDIS,¹ P. KORANTZOPOULOS,²T. VOUGΙOUKLAKIS,³ M. KIRIOU,¹ V. DIMITROULA,² L.K. MICHALIS,¹ J. GOUDEVENOS¹
¹Department of Cardiology, University of Ioannina, Medical School, Ioannina,
²Department of Cardiology, "G. Hatzikosta" General Hospital, Ioannina,
³Laboratory of Forensic Medicine, University of Ioannina, Medical School, Ioannina, Greece

OBJECTIVE Ischemic heart disease (IHD) presents as acute coronary syndrome (ACS) with or without ST segment elevation, sudden cardiac death, stable angina, silent ischemia or cardiac failure. The aim of this study was to determine the incidence and the clinical presentations of IHD in an isolated area of northwestern (NW) Greece with 170,000 inhabitants.

METHOD Over a one-year period a prospective, population-based survey was conducted of first presentation of IHD cases. Every patient living in the study area, aged <80 years, without a history of coronary artery disease, who presented with symptoms suspicious for IHD, was eligible for inclusion in the study. For sudden cardiac deaths, relevant information was obtained from the autopsy report or from the doctor who documented the death. Additional information regarding timing and associated conditions was obtained from relatives. The diagnosis and classification of the cases studied was performed according to World Health Organization and European Society of Cardiology criteria.

RESULTS A total of 408 patients (308 men, 100 women, mean age 62.5±10 and 68.0±9.5 years, respectively) were identified who had a first appearance of IHD (174 non-ST elevation ACS, 105 ST elevation ACS, 73 sudden cardiac deaths, 40 stable angina, 12 silent ischemia and 4 cardiac failure). In addition, 122 cases with chest pain but normal electrocardiogram at rest, normal enzymes (CK, troponin) and with normal coronary angiography studies, were excluded. The annual incidence for the 30-79 years age group was 45.2/10,000 inhabitants (70.2 for men and 20.9 for women). The incidence of IHD increased with age in both sexes and was higher in men, even after the age of 70 years.

CONCLUSIONS IHD is common in the area of NW Greece, and in the majority of cases presents in a form amenable to therapeutic manipulation. Twenty percent of the patients died suddenly. Preventive measures and acute management facilities need to be improved, even in a mediterranean country where the incidence of ischemic heart disease is relatively lower than in northern european countries.

Key words: Acute coronary syndromes, Epidemiology, Incidence, Ischemic heart disease, Sudden cardiac death.