1. INTERNATIONAL CONGRESS OF CAD
REVIEW OF MAJOR NON MAJOR RISK FACTORS OF CORONARY ARTERY DISEASE IN “JAVAD AL AEMEH “ HEART HOSPOTAL OF MASHHAD.
5-7 OCT. 2011
Dr. M Mohammadi cardiologist

2. Agency for Health Care Policy and Research (AHCPR) 1995: Cardiovascular disease is the leading cause of morbidity and mortality in united states,accouting for 50% of all deaths.

3. Global Perspective Ischemic heart disease Ischemic heart disease
leading causes of mortality
1990
leading causes of mortality
2020
Ischemic heart disease
Cerebrovascular disease
Lower respiratory disease
……………….
Road – traffic accidents
Throat and lung cancers
Ischemic heart disease
Unipolar major depression
Road – traffic accidents
Cerebrovascular disease
COPD
Lower respiratory disease
……………….
War injuries
HIV

4. 2. Method 2.1. Study area and population
From 21 November 2006 to 20 November 2007, patients with a new stroke in defined study areas ( residents) were identified.

5. No strokes were found in children aged less than 15 years.
The incidence rates increased significantly with each decade of life and were similar in men and women

6. Ischaemic strokes are occurring approximately one decade earlier than in other countries

7. Discussion: Major finding
1- The incidence of stroke was approximately double that of the majority of ‘ideal’ studies conducted in the last decade
2-It was greater than in most western countries with the exception of the Ukraine
3-It was even higher than those of Novosibirsk, Russia; a region known for its high incidence of stroke
4-The crude incidence rate of stroke was relatively low which is related to our younger population.
5- Ischaemic strokes are occurring approximately one decade earlier than in other countries
6- The high incidence of total stroke is largely attributable to a high incidence of IS.
7-It also appears that the incidence of ICH is greater than in all other countries except Georgia
Mihalka L, et al.A population study of stroke in West Ukraine: incidence, stroke services, and 30-day case fatality. Stroke
Tsiskaridze A, et al. Stroke incidence and 30-day case-fatality in a suburb of Tbilisi: results of the first prospective population-based study in Georgia. Stroke. 2004
Feigin VL, et al.Stroke epidemiology in Novosibirsk, Russia: a population-based study. Mayo Clin Proc

8. Discussion:
The reason for the high incidence of stroke in Mashhad, and the fact that stroke occurs at younger ages, is not clear: 1- It might be related to race-ethnic differences 2-Different types of vascular risk factors and their control, 3- The effect of socioeconomic status on stroke

9. Discussion:Risk factors
When assessing risk factors:
1- The proportion of people with diabetes appears to be greater than in other stroke studies
2-There also seems to be a large proportion of stroke patients, particularly women, with a history of hypertension
3-Risk factors were not well controlled in our population
Rothwell PM, et al. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). Lancet. 2004

10. Summary:
In summary, the MSIS provided valid and comparative data on the incidence of stroke in Iran as an area in the Middle-East.
The incidence of stroke, IS, and ICH were greater than incidence figures reported in most other regions of the world, and strokes occurred at younger ages.

11. RISK FACTORS FOR ATHEROTHROMBOTIC DISEASE
SMOKING
HYPERTENSION
HYPERLIPDEMIA
FAMILY HISTORY
DIABETES MELITUS
OBESITY

14. اثرسیگار بر(CAD) 676 بیمار کنگره سلامتی و سیگار بندر عباس-دی86

16. تعداد سیگاری ها در هر گروه سنی

18. جمعیت اماری مورد مطالعه 89-84 900بیمار

19. فراوانی سنی

20. نسبت مرد / زن در جمعیت مورد مطالعه

21. SMOKING/ 278cases /30.88%

22. HYPERTENSION 380cases 42.22%

23. HYPERLIPIDMIA 417cases 46.33%

24. DIABETES 226cases 25.11%

25. FAMILY HISTORY 250cases 27.77%

26. مقایسه کلی ریسک فاکتورها

27. تعداد مردان بدون ریسک فاکتور ماژور/کل مردان/کل جمعیت 40
تعداد مردان بدون ریسک فاکتور ماژور/کل مردان/کل جمعیت 40.99% بدون ریسک فاکتور ماژور

28. تعداد زنان بدون ریسک فاکتور ماژور/کل زنان /کل جمعیت 44
تعداد زنان بدون ریسک فاکتور ماژور/کل زنان /کل جمعیت % بدون ریسک فاکتور ماژور

29. ATHEROTHROMBOTIC RISK FACTORS:
High sensitivity C –reactive pr.
Homocysteine
Lipoprotein(a)
Fibrinogen
D-dimer
Abnormalities of intrinsic fibrinolysis