Darbingo amžiaus gyventojų sergamumas miokardo infarktu, jį lemiantys rizikos veiksniai ir išgyvenamumas 2005–2015 metais ; Myocardial Infarction Morbidity, Risk Factors and Survival in Working Age Population in 2005– 2015

Abstract

Author: Mantas Čekanauskas. Title: Myocardial infarction morbidity, risk factors and survival in working age population in 2005– 2015. Aim: To review data found in scientific literature about myocardial infarction morbidity, risk factors and survival in working age population in 2005–2015. Tasks: To evaluate morbidity of myocardial infarction and its changes in Lithuania and European Union. To summarize etiology, main symptoms and principles of diagnostics. To identify the most significant risk factors for men and women. To evaluate survival, its changes and factors that contribute to it. Method: Search of scientific literature and data was done using PubMed, Lithuanian Academic Electronic Library (eLaBa), Lithuanian Institute of Hygiene and WHO Regional Office for Europe "Health for all" databases. Keywords used in research were: "myocardial infarction" and "young", "young people", "young adults", "young men", "young women", "men", "women", "characteristics", "pathogenesis", "diagnosis", "risk factors", "epidemiology", "morbidity", "survival", "mortality", "in hospital mortality", also "miokardo infarktas", "sergamumas", "išgyvenamumas", "mirštamumas", "rizikos veiksniai", "darbingo amžiaus". Only studies that were made with humans, written in English or Lithuanian and published not earlier than 10 years ago were selected. Articles that analyzed 65 years old and older population as well as younger than 18 years old people and those in which myocardial infarction was not the main analyzed topic were rejected. Additionally, other scientifical articles that corresponded to the topic of this paper were analyzed, prioritizing literature published not earlier than 10 years ago or articles written by Lithuanian authors. Conclusions: The number of hospitalizations due to ischaemic heart disease and myocardial infarction is slowly decreasing in EU (European Union) with the numbers being lowest in southern countries and biggest in Baltic and Scandinavian countries. The numbers in Lithuania remain the highest among all countries in the EU. The morbidity of myocardial infarction in Lithuania increased throughout 2005–2015. The morbidity in men was a few times higher than in women. Men aged 45 to 64 took the highest part among all patients. Myocardial infarction usually occurs as a result of thrombus forming in a coronary artery after a rupture of atheroma. The most common clinical manifestation is chest pain lasting 20 minutes or longer. Diagnosis is made after collecting patient's anamnesis, finding increased Troponin levels in blood serum and making other necessary examinations. The most important risk factors for 18–64 years old people are smoking, dyslipidaemia, diabetes and hypertension. Women experienced their first myocardial infarction later than men. Dyslipidaemia significantly increases the risk for men, while comorbidities for women. In recent years, numbers of hypertension and diabetes have increased among middle-aged, while numbers of smoking have decreased among younger MI patients. Mortality from ischaemic heart disease (including mortality from myocardial infarction) in Lithuania and Europe was decreasing throughout the period, even though in Lithuania it is still higher than the average of EU and is among the highest in the Union. Despite decreasing rates, this tendency is least noticeable among young women. General mortality among working age men decreased averagely -4,7 percent/year., p<0,05, among women -2,0 percent/year, p=0,16, among young men -7,8 percent/year, p<0,05, among young women -1,1 percent/year, p=0,56, among middle-aged men -4,5 percent/year, p<0,05, among middle-aged women -2,3 percent/year, p=0,16 respectively. Young women also got sufficient treatment later and less often than the other groups. The risk of mortality for patients who had experienced MI decreased a few times in 1980–2009. Previous acute heart failure worsened long-term survival for all patients, while additionally previous acute MI, stroke, and obesity was related with lower chances of survival in men, whereas stroke and diabetes in women. Overweight was associated with better prognosis for both men and women.