[Coronary disease in France: data from the MONICA registers (1985-1991)].
Level 3 - non-randomized controlled study
Multi-center population-based epidemiological surveillance registry (1985-1991)
What was done
From 1985 to 1991, continuous and exhaustive registration of acute coronary events (15,775 cases: 12,789 men and 2,986 women) was conducted in three French MONICA Centers (Lille, Strasbourg, and Toulouse) to assess fluctuations in coronary heart disease (CHD) morbidity and mortality, comparing registry findings with official death certificate statistics.
What was found
Official male CHD mortality rates were 93 per 100,000 in Lille, 84 per 100,000 in Strasbourg, and 57 per 100,000 in Toulouse. Official rates matched MONICA registry rates only when restricted to documented myocardial infarctions; adding sudden deaths increased the rates by a factor of 1.6. Official statistics showed a 33% decline in mortality, whereas MONICA recorded a 20% decrease. Morbidity rates were similar between northern and southern centers, with an improving trend in myocardial infarction recurrence alongside worsening initial incidence.
Why it matters
Routine vital statistics can underestimate total coronary mortality and overestimate the speed of mortality reductions when sudden cardiac deaths are omitted.
Limits
The abstract reports data from only three geographic areas (Lille, Strasbourg, Toulouse), limiting direct national generalizability. Specific confidence intervals, statistical tests, and absolute baseline incidence rates are not provided in the abstract.
Cited by
- supports Toulouse has the lowest rate of coronary artery disease in France.