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European Heart Journal Advance Access published online on July 11, 2005

European Heart Journal, doi:10.1093/eurheartj/ehi412
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received February 15, 2005
Revised June 2, 2005
Accepted June 16, 2005

Clinical research

Differences between coronary disease and stroke in incidence, case fatality, and risk factors, but few differences in risk factors for fatal and non-fatal events

Lars Wilhelmsen 1*, Max Köster 2, Per Harmsen 1, and Georg Lappas 1

1 Section of Preventive Cardiology, The Cardiovascular Institute, Göteborg University, Drakegatan 6, SE-412 50 Göteborg, Sweden
2 Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden

* To whom correspondence should be addressed.
Lars Wilhelmsen, E-mail: lars.wilhelmsen{at}scri.se


   Abstract

Aims To compare incidence and mortality of coronary and stroke events, and risk factors for non-fatal and fatal events, respectively.

Methods and results Incidence and mortality were compared in all coronary (n = 559 341) and stroke (n = 530 689) events in Sweden from 1987 to 2001. Data from 28 years of follow-up of a random sample of 7400 men aged 47-55 and free of disease at baseline were used to compare risk factors. Incidence and 28 days of case fatality were considerably higher for coronary disease than for stroke, especially for men. Incidence of coronary disease decreased, especially for men (P = 0.0001 for both sexes), and mortality declined for both men and women during 1987-2001 (P = 0.0001 for both sexes). Stroke incidence declined slightly (P = 0.0001 for both sexes), and there was a decline of mortality (P = 0.0001 for both sexes). Out-of-hospital mortality during the first 28 days was higher than in-hospital mortality for coronary events, whereas for stroke, in-hospital mortality was higher (in men) or the same (in women) as out-of-hospital mortality. High serum cholesterol was a strong risk factor for coronary events, but not for stroke. High blood pressure was a stronger risk factor for stroke. About 50% of men with both stroke and coronary disease died from coronary disease.

Conclusion Several differences regarding incidence, mortality, prognosis, and risk factors for stroke and coronary disease point towards different pathologies.

Keywords: Coronary disease; Stroke; Incidence; Mortality; Risk factors; Pathology.
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