Comparative epidemiology of stroke and acute myocardial infarction: the Dijon Vascular Project (DIVA)

Abstract

Background: Despite a common pathophysiological mechanism, i.e. atherosclerosis, and similar vascular risk factors, few reliable studies have compared the epidemiology of stroke and acute myocardial infarction (AMI).

Methods: We prospectively recorded all first-ever cases of stroke and AMI in Dijon, France (151,846 inhabitants) from 2001 to 2006. The 30-day case fatality rates (CFR) and the vascular risk factors were assessed in both groups.

Results: Over the 6 years, we recorded 1660 events (1020 strokes and 640 AMI). Crude incidence of stroke was higher than that of AMI (112 versus 70.2/100 000/year, p<0.001). With regard to the sex, the relative incidence of stroke compared to AMI was 0.88 (95% CI 0.60-1.29, p=0.51) in women < 65 years, and 2.32 (95% CI 1.95-2.75, p< 0.001) in those > 65 years, whereas it was 0.60 (95% CI 0.42-0.86, p<0.001) in men below 55 years, 1.01 (0.81-1.24, p=0.96) in those between 55 and 75 years and 2.01 (95% CI 1.48-2.71, p<0.001) at 75 years and older. CFR at 30 days were similar for stroke and AMI (9.80 % versus 9.84 %, p=0.5). Hyperglycemia (>7.8 mmol/l) at onset was significantly associated with higher CFR in both stroke and AMI patients. The prevalence of male sex, hypercholesterolemia, and diabetes was higher in AMI patients whereas hypertension was more frequent in stroke patients.

Conclusion: Our findings will help health care authorities to evaluate future needs for stroke and AMI services, and to develop secondary prevention strategies.