Épidémiologie de l'infarctus du myocarde

Abstract

Because of its high frequency and mortality rates, myocardial infarction has a particular place among cardiovascular diseases. Its rising incidence and mortality rate (proportional to living standards) have been studied in large trials such as the MONItoring of trends and determinants of CArdiovascular disease (MONICA) project, initiated by the World Health Organization, which has brought to light the great geographical disparity of the disease throughout the world and in each studied country, with, most of the time, a North-South gradient. There is also a temporal dynamics specific of the epidemiology of myocardial infarction: in some countries, the disease is receding, but in some others, its frequency is alarmingly increasing. Among all the determining factors, some cannot be modified, such as age, gender, heredity or clearly identified previous history. However, some others can be modified, like hypertension, dyslipidaemia, smoking, nutrition, socio-economical and environmental conditions. All these factors are strongly related to the incidence of the disease. More recent theories such as vitamin deficiency or genetic particularity still need to be confirmed, but they constitute new research subjects since they could induce therapeutic progress and means for primary and secondary prevention.