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Volume 6, Issue 5(Suppl) Epidemiology (Sunnyvale)
ISSN: 2161-1165 ECR, Open Access
Page 96
Epidemiology 2016
October 3-5, 2016
conferenceseries.com
Epidemiology & Public HealthOctober 3-5, 2016|London, UK
4th International Conference on
SOCIAL INEQUALITIES IN THE INCIDENCE OF CORONARY HEART DISEASE AND STROKE IN
EUROPE: TESTING THE DIFFERENTIAL VULNERABILITY HYPOTHESIS
Marco M Ferrarioa
aUniversity of Insubria, Varese, Italy
S ocial inequalities constitute a relevant topic in the epidemiology literature. Recent research questioned whether social po-
sition interacts with risk factors, exacerbating their unfavourable effects, under a “differential vulnerability” mechanism
When measured on an additive scale such as the absolute risk of event, the interaction between social class and risk factors
provides valuable information on which subgroups in the population may benefit most by preventive strategies. However, this
important mechanism has been under-investigated so far, as large prospective studies are needed to provide precise interaction
estimates. We tested the differential vulnerability hypothesis in incident coronary heart disease and stroke using data from 11
populations in 9 European countries, all participating in the MORGAM collaborative project, with harmonized baseline and
follow-up data. Overall, 77 918 men and women with 9334 incident events occurring during a median follow-up of 12 years.
We found evidence that low education exacerbates the effect of cardiovascular disease risk factors on the absolute risk of coro-
nary heart disease or stroke between the ages of 35 and 75, in individuals initially free of CVD. In men, this synergistic interac-
tion was mainly driven by smoking; in women by clustering of smoking, elevated blood pressure and obesity. Standard survival
analysis, ignoring competing risks, led to over-estimating the interaction between low education and risk factors, in particular
smoking and body mass index. Our study calls for future research pursuing explanations for the differential vulnerability we
demonstrated, such as the accumulation of psychosocial stressors and allostatic load among the socially disadvantaged over
lifetime.
CREATINEPHOSPHOKINASE MB FRACTION (CK-MB) AS A EARLY CARDIAC MARKER
IN PATIENTS INFECTED BY TRYPANOSSOME CRUZI IN BELÉM – PARÁ – BRASIL
Frederico AR Nevesa
aInstituo Evandro Chagas, Brazil
C hagas disease is anthropozoonosis caused by the protozoan Trypanosome cruzi ( T. cruzi ), mainly transmitted by insect
vectors of the Reduviidae family. It is distributed throughout the Americas. It is estimated that in Brazil 25 million people
live in risk areas and five million are infected. Creatinephosphokinase MB fraction has long been considered a marker for the
diagnosis of myocardial injury, caused by this parasite. This study aims to evaluate the prognostic value in laboratory scope of
CK- MB in patients diagnosed with Trypanossome cruzi infection. Transversal study where we selected 24 patients treated at
health centers in Belem - Pará - Brazil , all with clinical signs and symptoms of infection by the parasite , infection confirmed
by testing Enzyme Linked Immuno Sorbent Assay ( ELISA) and testing haemagglutination Inhibition ( HAI) . Was used for
measurements of serum CK- MB in the method of Enzyme linked fluorescent assay ( ELFA ) by bioMérieux®. In 41.6 % of cases
the CK- MB remained at normal levels < 5.0 µg / ml and in 58.4 % CK -MB is altered > 5.0ug / ml. In patients where the CK-
MB was changed mainly seemed to be a direct relation of infection time, since this marker appears to have more sensitivity
when the heart muscle is already showing necrosis, thus demonstrating a more advanced disease compared to patients that
show normal rates. Creatinephosphokinase MB fraction apparently not presented with a good marker for the early diagnosis
of myocardial injury.
Epidemiology (Sunnyvale), 6:5(Suppl)