The EuroMed Programme was launched by the European Commission in 2008 with the purpose of promoting integration and democratic reform across North Africa and Middle East Countries neighbours to the EU south. In the framework of this programme, the Italian Ministry of Health took the lead of initiatives aimed at strengthening health systems, fighting chronic diseases and developing preventive services. It assigned the project: “A population-based AMI register: assessing the feasibility for a pilot study to implement a surveillance system of acute myocardial infarction (AMI) in Mediterranean Countries according to Eurociss recommendations” to the Italian National Institute of Health, Istituto Superiore di Sanità (ISS), where the Cardiovascular Epidemiology Department set up a population based registry of cardiovascular diseases (CVD) and developed a validated simplified methodology able to facilitate the setting up and the implementation of CVD surveillance systems by utilizing a step-wise procedure as described in the European Cardiovascular Indicators Surveillance Set (EUROCISS) Project. EUROCISS was launched in 2000 by a partnership of EU countries with the aim of developing health indicators and recommendations for monitoring the distribution and impact of CVD in Europe in order to facilitate cross-country comparisons and improve CVD prevention and control.

 

The registry procedure is based on standardised data collection, appropriate record linkage and validation methods, according to scientific criteria defined by WHO, the European Society of Cardiology and the American College of Cardiology.

 

Incidence/attack rate, case fatality of acute events and prevalence of chronic conditions were recommended for inclusion in the European Community Health Indicators Monitoring (ECHIM) short list, as they provide important information on morbidity, mortality, disability and survival rate; incidence/attack rate and case fatality are drawn from routine databases and are processed after being pooled and validated. Incidence is particularly relevant in the case of acute events and useful for etiological research objectives; attack rate - which includes fatal and non-fatal, new and recurrent events occurring in and out of hospital - is important for disease surveillance, distribution and trend.

 

The EuroMed project on CVD has the purpose of assessing the feasibility of setting up a surveillance system for the Acute Myocardial Infarction (AMI) in Mediterranean Countries that lack appropriate surveillance systems and wish to implement a population-based register in order to prevent the disease.

Two countries have been selected for the project: Croatia and Egypt.

Training sessions for the AMI registry setting up have taken place in Zagabria.

Within the EuroMed project, it has been developed and implemented the English version of the software that allows the record linkage of the sources of information (mortality data and hospital discharge records) which are needed for the AMI population-based register. Moreover, it calculates coronary events fatal and non-fatal attack rates and case-fatality rates for the population under surveillance.

• download the software

References:

• Madsen M, Gudnason V, Pająk A, Palmieri L, Rocha RC, Salomaa V, Sans S, Steinbach K, Vanuzzo D, a nome del EUROCISS Research Group, Population-based register of acute myocardial infarction: manual of operations. Eur J Cardiovasc Prev and Rehab 2007;14(Suppl 3):S3-22.
• Giampaoli S, Hammar N, Adany R, De Peretti C, a nome del EUROCISS Research Group, Population-based register of stroke: manual of operations. Eur J Cardiovasc Prev and Rehab. 2007;14(Suppl 3):S23-41.
• Palmieri L, Barchielli A, Cesana G, de Campora E, Goldoni CA, Spolaore P, Uguccioni M, Vancheri F, Vanuzzo D, Ciccarelli P, Giampaoli S., a nome del gruppo di ricerca del Progetto Registro per gli Eventi Coronarici e Cerebrovascolari, The Italian register of cardiovascular diseases: attack rates and case fatality for cerebrovascular events. Cerebrovasc Dis 2007;24(6):530-539
• Gruppo di ricerca del Progetto Registro per gli Eventi Coronarici e Cerebrovascolari, Registro nazionale italiano degli eventi coronarici maggiori: tassi si attacco e letalità nelle diverse aree del Paese. Ital Heart Journal Suppl 2005; 6(10): 667-673.
• Palmieri L, Dima F, Bolognesi L, Sarman S, Lo Noce C, Chiodini P, Naldoni P, Ferrario M, Vanuzzo D, Vancheri F, Giampaoli S e il Gruppo di Ricerca del Registro Nazionale degli eventi Coronarici e Cerebrovascolari, Registro per gli eventi coronarici e cerebrovascolari. Manuale delle operazioni. Rapporti ISTISAN 2003;03/35:1-151.
• Ferrario M, Cesana G, Vanuzzo D, Pilotto L, Sega R, Chiodini P, Giampaoli S. Surveillance of ischemic heart disease: results from the Italian MONICA populations. Int J Epidemiol 2001;30:S23-S29.
• Ferrario M, Giampaoli S, Vancheri F, Vanuzzo D. Registro per gli eventi coronarici e cerebrovascolari. Protocollo dello studio. Rapporti ISTISAN 2001; 01/8: 1-89.
• Tunstall-Pedoe H, Kuulasmaa K, Mähönen M, Tolonen H, Ruokokoski E, Amouyel P. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. The Lancet 1999; 353:1547-57.
• Ferrario M, Cesana G, Vanuzzo D, Pilotto L, Sega R, Giampaoli S. Sorveglianza epidemiologica della occorrenza della cardiopatia ischemica: risultati dalle aree MONICA italiane e proposta di un modello semplificato di stima. Giornale Italiano di Cardiologia 1999;29:161-167.