Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

Abstract Background The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. Methods We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. Results Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = − 0.68 and − 0.83, respectively) and prostate cancer (EAPC = − 0.75 and − 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. Conclusions Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.

Download Full-text

Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017

Journal of Hematology & Oncology ◽

10.1186/s13045-019-0828-0 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 39

Author(s):

Na Li ◽

Yujiao Deng ◽

Linghui Zhou ◽

Tian Tian ◽

Si Yang ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Burden Of Disease ◽

Attributable Risk ◽

Global Burden Of Disease ◽

Global Burden ◽

Cancer Burden ◽

Cancer Data ◽

Life Years ◽

Incident Cases

Abstract Background Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017. Methods We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study. Results In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose. Conclusion The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.

Download Full-text

Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

BMJ Global Health ◽

10.1136/bmjgh-2020-004128 ◽

2021 ◽

Vol 6 (11) ◽

pp. e004128

Author(s):

Saeid Safiri ◽

Ali-Asghar Kolahi ◽

Mohsen Naghavi

Keyword(s):

Risk Factors ◽

Bladder Cancer ◽

Death Rate ◽

Attributable Risk ◽

Mortality Data ◽

Years Of Life Lost ◽

Death Rates ◽

Life Years ◽

Incident Cases ◽

Mortality Estimates

IntroductionThe current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors).MethodsVarious data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population.ResultsGlobally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)).ConclusionsThere was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.

Download Full-text

The global, regional, and national burden of kidney cancer and attributable risk factor analysis from 1990 to 2017

Experimental Hematology and Oncology ◽

10.1186/s40164-020-00181-3 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Xianguang Bai ◽

Ming Yi ◽

Bing Dong ◽

Xinhua Zheng ◽

Kongming Wu

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Incidence Rate ◽

Kidney Cancer ◽

High Body Mass Index ◽

Developed Countries ◽

Attributable Risk ◽

Incidence And Mortality ◽

Global Burden Of Diseases ◽

Associated Risk Factors

Abstract Background Kidney cancer’s incidence and mortality vary in different regions and countries. To compare and interpret kidney cancer’s burden and change trends in the globe and in different countries, we conducted this study to report the global kidney cancer burden and attributable risk factors. Methods Data about kidney cancer’s incidence, death, disability-adjusted life-year (DALY) were extracted from the Global Burden of Diseases 2017. Besides, social-demographic index (SDI) values were adopted to investigate the correlation between kidney cancer’s burden and social development degrees. Results In the globe, the incidence case of kidney cancer increased sharply from 207.31*103 in 1990 to 393.04*103 in 2017. High SDI countries had the highest kidney cancer’s burden with a decreased trend in incidence rate. On the contrary, the incidence rate was rapidly increased in low-middle SDI countries, although their burden of kidney cancer kept relatively low. At the same time, the deaths of kidney cancer increased from 68.14*103 to 138.53*103, and the kidney cancer-related DALYs increased from 1915.49*103 in 1990 to 3284.32*103 in 2017. Then, we searched the GBD database for kidney cancer-related risk factor. The high body-mass index and smoking were the main factors contributing to kidney cancer-related mortality. Conclusions Generally, from 1990 to 2017, the incidence rate in developed countries had gone down from the historic peak values while the incidence rate was still on the rise in developing counties. Given the aging trend in the globe, it is necessary to appeal to the public to decrease the exposure of kidney cancer-associated risk factors.

Download Full-text

Global, Regional, and National Burden of Breast Cancer and Its Attributable Risk Factors Among Women, 1990–2017

10.21203/rs.3.rs-97176/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Saeid Safiri ◽

Mohsen Naghavi

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Death Rate ◽

National Level ◽

High Body Mass Index ◽

Attributable Risk ◽

Death Rates ◽

Awareness Campaigns ◽

Life Years ◽

Increasing Trend

Abstract Introduction: Breast cancer is the most common cancer in women worldwide. However, no comprehensive study has been conducted to compare the incidence, mortality, and disability-adjusted life years (DALYs) for female breast cancer among different countries. The current study examined the level and trends of incidence, death, and DALYs for breast cancer and its attributable risk factors among women in 195 countries from 1990 to 2017 by age, socio-demographic index (SDI; a composite of socio-demographic factors), and healthcare access and quality (HAQ; an indicator of health system performance) index.Methods: Vital registration, verbal autopsy, and cancer registries were used across the globe to generate estimates. Incidence, mortality, and DALYs were estimated. All estimates are presented as counts and age-standardised rates per 100,000 person-years. Results: Between 1990 and 2017 the global incidence of breast cancer increased significantly by 17.1% (95% uncertainty interval [UI]: 7.1–23.6; with 1.9 million incidences in 2017 [95% UI 1.9–2.0]; age-standardised rate of 45.9 [95% UI: 44.2–47.4]). However, over this same period the age-standardised death rate significantly decreased by 10.6% (95% UI: -19.5 to -4.4), with 600.7 thousand deaths in 2017 (95% UI: 578.7–630.0; age-standardised death rate of 14.1 95% UI: 13.6–14.8). Global DALYs also significantly decreased between 1990 and 2017 by 9.3% (95% UI: -19.9 to -1.6) with 17.4 million DALYs reported in 2017 (95% UI: 16.6–18.4; age-standardised rate of 414.7; 95% UI: 395.5– 437.6). Lebanon [138.3 (95% UI: 106.5–170.7)], the Netherlands [109.8 (95% UI: 97.4–122.7)], and the UK [102.6 (95% UI: 99.6–105.8)] had the three highest age-standardised incidence rates in 2017. Meanwhile, Pakistan [34.1 (95% UI: 20.9–71.3)], Tonga [34.0 (95% UI: 26.8–41.9)], and the Bahamas [33.3 (95% UI: 28.9–37.8)] had the three highest age-standardised death rates in 2017. Between 1990 and 2017, Saudi Arabia [232% (95% UI: 93–410)], Mauritius [174% (95% UI: 134–222)], and Taiwan [172% (95% UI: 141–208)] showed an increasing trend for the highest age-standardised incidence rate of breast cancer. Meanwhile, Mauritius [90% (95% UI: 66–117)], Philippines [76% (95% UI: 43–115)], and the Dominican Republic [69% (95% UI: 11–125)] produced the greatest significant increasing trend in age-standardised death rates. An increasing trend between population ageing and age-standardised incidence and death rates were observed globally, peaking among the oldest population grouping [incidence: 535.6 (95% UI: 511.8–560.7); death: 251.4 (95% UI: 242.6–260.9)]. Non-linear associations were observed between age-standardised DALY rates with SDI and HAQ. Alcohol consumption [9.2% (95% UI: 7.7–10.7)], high fasting plasma glucose [6.1% (95% UI: 1.1–13.6)], and high body mass index [4.5% (95% UI: 1.4–8.5)] were the three largest contributors to breast cancer DALYs globally.Conclusions: Remarkable inter-country variation exists in the burden of breast cancer. While there is a global downward trend in breast cancer age-standardised mortality rates, some countries are experiencing increases in age-standardised incidence and death rates from breast cancer. Prevention measures should be tailored to national-level estimates specific for each country and strengthened through early detection and treatment and public policy awareness campaigns aimed to reduce exposure to modifiable risk factors, particularly for countries with high incidence levels and/or increasing trends.

Download Full-text

The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Frontiers in Oncology ◽

10.3389/fonc.2021.689562 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shangbo Xu ◽

Yiyuan Liu ◽

Taofeng Zhang ◽

Jiehua Zheng ◽

Weixun Lin ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Fasting Plasma ◽

Life Years ◽

High Fasting Plasma Glucose

BackgroundThe burden of breast cancer has been increasing globally. The epidemiology burden and trends need to be updated. This study aimed to update the burden and trends of breast cancer incidences, deaths, and disability-adjusted life-years (DALYs) from 1990 to 2019, using the Global Burden of Disease 2019 study.MethodsThe data of incidences, deaths, DALYs, and age-standardized rates were extracted. Estimated annual percentage changes were used to quantify the trends of age-standardized rates. Besides, the population attributable fractions of the risk factors of breast cancer were also estimated.ResultsGlobally, the incidences of breast cancer increased to 2,002,354 in 2019. High social-development index (SDI) quintiles had the highest incidence cases with a declining trend in age-standardized incidence rate. In 2019, the global deaths and DALYs of breast cancer increased to 700,660 and 20,625,313, respectively. From 1990 to 2019, the age-standardized mortality rates and age-standardized DALY rates declined globally, especially in high and high-middle SDI quintiles. Besides, the trends varied from different regions and countries. The proportion of the patients in the 70+ years age group increased globally. Deaths of breast cancer attributable to high fasting plasma glucose and high body mass index increased globally, and high fasting plasma glucose was the greatest contributor to the global breast cancer deaths.ConclusionThe burden of breast cancer in higher SDI quintiles had gone down while the burden was still on the rise in lower SDI quintiles. It is necessary to appeal to the public to decrease the exposure of the risk factors.

Download Full-text

Global Burden and Attributable Risk Factors of Acute Lymphoblastic Leukemia in 204 Countries and Territories from 1990-2019: Estimation Based on Global Burden of Disease Study 2019

10.21203/rs.3.rs-508326/v1 ◽

2021 ◽

Author(s):

Yuefen Hu ◽

Xiuping Zhang ◽

Aijun Zhang ◽

Yu Hou ◽

Yang Liu ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Acute Lymphoblastic Leukemia ◽

Body Mass ◽

Burden Of Disease ◽

Lymphoblastic Leukemia ◽

High Body Mass Index ◽

Attributable Risk ◽

Global Burden ◽

Disease Study

Abstract Purpose: To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, a latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped.Methods: Based on the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) values to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years (DALYs) were estimated by the comparative risk assessment framework. Results: We found that new ALL cases increased significantly by 129% worldwide, and the age-standardized incidence rate (ASIR) increased by 1.61 percent per year. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. Conclusion: The global burden of ALL has steadily increased, especially in middle SDI region. Health measures should be taken into consideration to improve the treatment of elders with ALL due to a great proportion in the higher SDI region. Attention should be paid to the environmental problems caused by industrial development in low SDI areas.

Download Full-text

Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017

BMJ ◽

10.1136/bmj.m234 ◽

2020 ◽

pp. m234 ◽

Cited By ~ 6

Author(s):

Xiaochen Li ◽

Xiaopei Cao ◽

Mingzhou Guo ◽

Min Xie ◽

Xiansheng Liu

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Burden Of Disease ◽

Respiratory Diseases ◽

High Body Mass Index ◽

Global Burden Of Disease ◽

Global Burden ◽

Chronic Respiratory Diseases ◽

Life Years ◽

Disease Study

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.

Download Full-text

The Global Burden and Attributable Risk Factors of Chronic Lymphocytic Leukemia in 204 Countries and Territories from 1990 to 2019: Analysis Based on the Global Burden of Disease Study 2019.

10.21203/rs.3.rs-824063/v1 ◽

2021 ◽

Cited By ~ 2

Author(s):

Yiyi Yao ◽

Xiangjie Lin ◽

Fenglin Li ◽

Jie Jin ◽

Huafeng Wang

Keyword(s):

Risk Factors ◽

Chronic Lymphocytic Leukemia ◽

Burden Of Disease ◽

Population Aging ◽

High Body Mass Index ◽

Lymphocytic Leukemia ◽

Global Burden Of Disease ◽

Global Burden ◽

Life Years ◽

Epidemiological Characteristics

Abstract Chronic lymphocytic leukemia (CLL) is the most prevalent subtype of leukemia in Western countries. Evaluation of the epidemiological characteristics of CLL is warranted, especially in the current context of global population aging. CLL data including incidence, mortality, and disability adjusted life-years (DALYs) were extracted and estimated annual percentage changes (EAPCs) were calculated from the 2019 Global Burden of Disease (GBD) study. Social-demographic index (SDI) was collected to investigate the impaction of social development degree on epidemiological trends and risk analysis. The global incidence of CLL has increased dramatically from 40,537 in 1990 to 103,467 in 2019. A high incidence has been achieved in males and elder people. Countries and territories with high SDI tended to have higher global burden than low-SDI region. Of the risk factors, high body mass index and smoking were the major contributors for CLL-related mortality and DALYs. In summary, the global CLL burden continues to rise over the past 30 years. Although most of the CLL incidence and death occurred in high-SDI regions, the CLL burden tends to grow rapidest in middle-SDI regions compared with high-/low-SDI regions. Therefore, it is necessary to pay special attention on taking further measures to alleviate the growing burden of CLL.

Download Full-text

Disease Burden and Attributable Risk Factors of Ovarian Cancer From 1990 to 2017: Findings From the Global Burden of Disease Study 2017

Frontiers in Public Health ◽

10.3389/fpubh.2021.619581 ◽

2021 ◽

Vol 9 ◽

Author(s):

Zhangjian Zhou ◽

Xuan Wang ◽

Xueting Ren ◽

Linghui Zhou ◽

Nan Wang ◽

...

Keyword(s):

Risk Factors ◽

Ovarian Cancer ◽

Data Exchange ◽

Disease Burden ◽

Temporal Trends ◽

High Body Mass Index ◽

Disability Adjusted Life Years ◽

Cancer Data ◽

Disability Adjusted Life ◽

Life Years

Aim: We aimed to estimate the disease burden and risk factors attributable to ovarian cancer, and epidemiological trends at global, regional, and national levels.Methods: We described ovarian cancer data on incidence, mortality, and disability-adjusted life-years as well as age-standardized rates from 1990 to 2017 from the Global Health Data Exchange database. We also estimated the risk factors attributable to ovarian cancer deaths and disability-adjusted life-years. Measures were stratified by region, country, age, and socio-demographic index. The estimated annual percentage changes and age-standardized rates were calculated to evaluate temporal trends.Results: Globally, ovarian cancer incident, death cases, and disability-adjusted life-years increased by 88.01, 84.20, and 78.00%, respectively. However, all the corresponding age-standardized rates showed downward trends with an estimated annual percentage change of −0.10 (−0.03 to 0.16), −0.33 (−0.38 to −0.27), and −0.38 (−0.32 to 0.25), respectively. South and East Asia and Western Europe carried the heaviest disease burden. The highest incidence, deaths, and disability-adjusted life-years were mainly in people aged 50–69 years from 1990 to 2017. High fasting plasma glucose level was the greatest contributor in age-standardized disability-adjusted life-years rate globally as well as in all socio-demographic index quintiles and most Global Disease Burden regions. Other important factors were high body mass index and occupational exposure to asbestos.Conclusion: Our study provides valuable information on patterns and trends of disease burden and risk factors attributable to ovarian cancer across age, socio-demographic index, region, and country, which may help improve the rational allocation of health resources as well as inform health policies.

Download Full-text

P1223Attributable risk proportion of uncontrolled low-density lipoprotein cholesterol in recurrent acute coronary syndromes

European Heart Journal ◽

10.1093/eurheartj/ehz748.0181 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Cordero ◽

M Rodriguez Manero ◽

V Bertomeu Gonzalez ◽

R Agra Bermejo ◽

J M Garcia Acuna ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Heart Disease ◽

Recurrent Events ◽

Smoking Habit ◽

Attributable Risk ◽

Cross Sectional ◽

Coronary Syndrome ◽

Incident Cases

Abstract Background Coronary heart disease is chronic condition that usually has recurrent events. Risk factors for incident coronary heart disease are well known conditions related to recurrences have not been clearly outlined. Attributable risk proportion (ARP) refers to the proportion of incident cases in subjects exposed to risk factors that are attributable to that risk factor so we analysed ARP in wide cohort of patients admitted for an acute coronary syndrome (ACS). Methods Cross-sectional analysis of all patients admitted in two hospitals between January 2006 and December 2016. ARP was calculated by the equation: prevalence in exposed – (prevalence in exposed/odds ratio). LDL uncontrolled was codified as >70 mg/dl in patients with previous cardiovascular disease; >100 mg/dl in patients with diabetes without previous cardiovascular disease or; >155 mg/dl in patients without cardiovascular disease. Results We included 7,518 patients, mean age 66.9 (12.9) years, 72.5% males, median GRACE score 143.2 (40.3) and 35.3% STEMI. Previous coronary heart disease total was present in 2,032 (23.2%) patients and they had statistically higher mean age (70.6±11.11 vs. 65.8±13.3), prevalence of diabetes (37.9% vs. 25.3%) and hypertension (72.9% vs. 53.3%) and lower smoking habit (15.5% vs. 30.9%). LDLc was lower in patients with previous coronary heart disease (90.3±33.8 vs. 111.7±38.1; p<0.01), as well as HDLc (33.5±14.29 vs. 35.9±35.5; p<0.01) and haemoglobin (13.5±3.7 vs. 14.0±2.4; p<0.01). Uncontrolled LDLc was present in 83.4% of the patients with previous coronary heart disease, in contrast to the 28.7% of patients without previous coronary heart disease; this resulted in an ARP of 13.8%. The ARP for diabetes and hypertension were 1.6% and 1.4%, respectively. Conclusions The proportion of attributable risk of uncontrolled LDL on recurrent ACS is 13.8% and, therefore, 1 out of every 7 recurrent ACS could be prevented by an accurate LDLc control.

Download Full-text