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Myocardial infarction occurrence in Jerusalem: a Mediterranean anomaly.

Abstract：

BACKGROUND:The Jewish population of Israel consumes a diet rich in polyunsaturated fatty acids with a relatively low proportion of saturated fat, has a small alcohol intake and a lipid profile characterized by low HDL-cholesterol and high lipoprotein(a) (Lp(a)). It is therefore of interest to compare occurrence rates of coronary heart disease (CHD) with those elsewhere. METHODS:The community-based event rate of CHD [comprising acute myocardial infarction (AMI) and CHD death] and case-fatality was determined in 1995-1997 by active surveillance among Jewish residents of the Jerusalem District aged 25-64 according to standardized WHO-MONICA criteria. We compared our findings with rates among MONICA populations in 21 countries. Twelve hundred and six events occurred in Jerusalem during approximately 399,000 [correction] person-years (930 non-fatal AMI and 276 CHD deaths). RESULTS:The age-adjusted incidence of CHD ranked high compared with the 21 countries (men third highest, women eighth highest), far exceeding the Mediterranean countries. In contrast, the pre-hospital mortality rate was low, similar to countries in the Mediterranean basin, and the 28-day case fatality was remarkably low, far lower than for any MONICA population in men, and second lowest in women. Correspondingly, the incidence of non-fatal AMI ranked extraordinarily high (men first, women third). The low case-fatality ranking persisted upon adjustment for treatment differences between populations. CONCLUSIONS:We report an unusual combination of a high incidence of CHD among Jewish residents of Jerusalem accompanied by extraordinarily low case fatality, the latter suggesting reduced susceptibility to lethal arrhythmias. Determinants of this anomaly require clarification.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Kark JD,Goldberger N,Fink R,Adler B,Kuulasmaa K,Goldman S

doi

10.1016/j.atherosclerosis.2004.08.022

keywords:

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

129-38

issue

1

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(04)00416-2

journal_volume

178

pub_type

杂志文章

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