[Myocardial Infarction Registry conducted forty years ago in Hungary]. / Infarktus Regiszter 40 év távlatából: 1971-2011.

AIMS: Authors summarize the most important findings of the Myocardial Infarction Community Registry conducted in Hungary 40 years ago. The report is important because data are not available on the internet through literature search and since 40 years such study has not been performed. The incidence of acute myocardial infarction in subjects older than 20 years of age in the population of South Pest with 400 000 inhabitants in 1971 was 50.9/10 000 in men and 23.7/10 000 in women. The mortality rate of myocardial infarction during the first year was 56.2% in men and 60.7% in women. Two-third of the first-year death occurred in the first 24 hours and 85% of it in the prehospital period. Only 6% of the patients with acute myocardial infarction were admitted and treated in Coronary Care Units. Based on the data of the Myocardial Infarction Community Registry, measures were introduced which decreased the 28-days mortality rate at the population level. CONCLUSIONS: Authors emphasize that in the last decades the diagnosis and treatment of myocardial infarction has substantially changed which makes it necessary to re-evaluate by epidemiologic methods the natural history, incidence and mortality of acute myocardial infarction in Hungary.

[Prevention of cardiovascular diseases: collaborative program]. / A szív- es erbetegségek megelozése: prevenciós osszefogás program.

The so-called Program for preventive collaboration model joins the expertise of specialists and GPs and as such allocates for the effective, cost saving, secure screening of individuals with high and intermediate cardiovascular risk and identifying asymptomatic patients within a big population. Based on SCORE risk assessment GPs define their patients cardiovascular risk. In Gottsegen György Institute of Hungarian Cardiology on patients with intermediate or high risk ankle-brachial doppler index, carotis intima media thickness, artery stiffness, microalbuminuria and left ventricular hypertrophy are diagnosed. Based on the results of non-invasive cardiovascular marker tests a mixed score is elaborated. The applicability of the score is then measured for the further risk assessment of individuals with intermediate or high CV risk. The collaboration of GPs and specialists along with the non-invasive cardiological tests are helpful in the early identification of patients with high cardiovascular risk and when making a decision about drug or non-drug treatments.

[Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries in a case-control study based on the INTERHEART study]. / A módosítható kockázati tényezok hatása a szívizominfarktus kialakulására 52 országra kiterjedo eset-kontroll vizsgálat az INTERHEART tanulmány alapján.

An international, standardised case-control study was established to assess the importance of risk factors for coronary heart disease worldwide. From 52 countries representing every inhabited continent 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension and/or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins and psychosocial factors to myocardial infarction was reported. Odds ratios and their 99% confidence limits for the association of risk factors to acute myocardial infarction and their population attributable risks were calculated. Smoking (odds ratio 2.87 for current vs never, population attributable risk 35.7% for current and former smoker vs never), raised apolipoprotein B / apolipoprotein A1 ratio (3.25 for top vs lowest quintile, population attributable risk 49.2 for top four quintiles vs lowest quintile), history of hypertension (1.91, 17.9%), diabetes (2.37, 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, 32.5), daily consumption of fruits and vegetables (0.70, 13.7% for lack of daily consumption), regular alcohol consumption (0.91, 6.7%), and regular physical activity (0.86, 12.2%) were all significantly related to acute myocardial infarction (p < 0.0001 for all risk factors, and p = 0.03 for alcohol). These associations were noted in men and women, old and young and in all regions of the world. Collectively these nine risk factors accounted for 90% of the population attributable risk in men and 94% in women. This finding suggests that approaches to prevention can be based on similar principles worldwide.