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I./4.1.: Epidemiology
In front of the tumorous diseases, in Hungary most deaths occur currently because of cardiovascular diseases. The patients’ death is most frequently due to the various forms of acute coronary disease, namely myocardial infarction and unstable angina, further named summarizingly as acute coronary syndrome (ACS), as well as its complications. Also the Hungarian data confirm that the incidence of cardiovascular diseases is increasing with the advancing age, however the employable, breadwinner younger age group is also affected to a great extent (Figure 1).
Data of 22 European countries relating to males show that the mortality rate of middle-aged male inhabitants due to coronary heart disease is higher than in Hungary only in Slovakia, Estonia, Latvia and Lithuania. Mortality rates due to coronary heart disease in Austria and in the Czech Republic are less than a half and about two thirds compared to the Hungarian data, respectively. (Figure 2).
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Unfortunately, the situation has shown only a moderate improvement in the recent years; according to data of 2009, mortality due to coronary disease of male population under 65 years was six time higher than in France. Currently in Hungary 300 of 100 000 inhabitants die due to coronary heart disease; this number is 150 in Germany. At the same time the therapy of coronary heart disease/ACS underwent a great development in the last 40 years; the decisive majority of patients can be saved by up-to-date intervention therapy administered in time. Most of them can be cured with no permanent disability. Also their quality of life is not deteriorating, what is important as most of the patients are active employees, breadwinners. Their curing saves thousands of families from severe existential problems, and relieves also the budget from significant social expenses (disability pension, welfare etc.).
The significant development of intervention cardiology network in Hungary which occurred during the recent decade makes its beneficial effect felt and – despite the above data which are relatively high in comparison to the international data – when considered as absolute value, the mortality due to myocardial infarction has significantly decreased: half so much patients die as compared to the data 10 years ago (7481 deceased patients were reported with the code of myocardial infarction in 2011; personal communication of Prof. Dr. Józan Péter – Central Statistical Office). Development of care means in part the development of pharmacologic therapy; several medications which clearly improve life expectances have become an organic part of the treatment up to now. In addition, with the help of 18 intervention centers in the country, immediate cardiac catheterization has become available for more than 90% of domestic inhabitants.
An organic part of the catheterization care is the so-called Budapest model, internationally renowned and functioning since 2003, which ensures immediate access to an intervention for nearly 3 millions of inhabitants of the Mid-Hungarian Region day and night. The essence of it is that the existing 5 centers of intervention in Budapest (Bajcsy-Zsilinszky Hospital, Buda Hospital of the Order of Clemency, Gottsegen György National Institute of Cardiology, Central Hospital of the Army and State Health Center, and Cardiologic Center, Semmelweis University) provide care for their own area on workdays between 8 AM and 6 PM; and one of the centers provides care for the whole region in the night and in weekends. More than 17 000 patients with acute myocardial infarction received this state of the art treatment during the recent 10 years, with results which are considered as very good also by international standards (e.g. the hospital mortality has been 3 to 3.5%).
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