Cassandra

CASSANDRA - REGICOR Project

10-year projection of coronary events in other regions

About the authors

The authors of the CASSANDRA program are medical investigators from the Municipal Institute of Medical Research (IMIM), a public organism devoted to scientific research in biomedicine and health sciences, and the training of highly qualified investigators in these fields. IMIM is one of the main institutions in the creation of the Biomedical Research Park of Barcelona (PRBB), an innovative scientific project that gathers a large number of investigators from all around the world.

The scientific production generated by IMIM includes some 200 publications per year in international journals. This productivity puts IMIM in the leading position among all the Spanish biomedical research centers. One of its most well-known activities is epitomized in the Unit of Lipids and Cardiovascular Epidemiology (ULEC), a consortium currently composed of two groups, Cardiovascular Epidemiology and Genetics and Cardiovascular Risk and Nutrition, led by Jaume Marrugat (MD PhD FESC), who has published more than 250 original manuscripts in peer-reviewed journals.

IMIM is structured into Research Programs, multidisciplinary in nature, involving the basic sciences, epidemiology, and clinical researchers from several hospitals in Barcelona and Girona. The ULEC was set up in 1992 and has been accredited as an Advanced Research Group by the Catalan Government since 1996 (renewed every 2 years). More than 350 original articles published in high impact international journals substantiate its scientific trajectory.

In the ULEC, a group of epidemiologists, biochemists, biologists, biostatisticians, cardiologists, internal medicine and intensive care physicians, neurologists, and vascular surgeons are teaming up to study cardiovascular diseases. This multidisciplinary effort approaches the research from different perspectives (biochemical, molecular, epidemiological, clinical, and genetic), which enriches the study of a multifactorial process such as cardiovascular disease.

The ULEC research lines, initiated in 1988, are focused on descriptive and clinical epidemiology, monitoring myocardial infarction incidence and the associated classic risk factors in a well-defined area of Spain. ULEC has extensive experience in the assessment of cardiovascular risk and has made relevant contributions to the adaptation and validation for the Spanish population of existing risk functions based on the classic cardiovascular risk factors. A Spain-North America collaboration agreement with the Framingham Heart Study researchers has led to more than 10 years of team work and the calibration of the Framingham function to adapt it for use with the population of Spain. This Framingham-REGICOR cardiovascular risk function has been validated in two cohort studies of approximately 5000 and 4000 Spanish participants followed 5 and 10 years, respectively, which showed that the Framingham-REGICOR function accurately predicts the 5-year and 10-year CHD risk in the respective cohorts. These adapted functions have been officially adopted by several Autonomous Communities in Spain.

ULEC has also reported important findings about the role of sex, genetic factors, and interactions between these and environmental factors in the context of the REGICOR study (Registre Gironí del Cor, or Gerona Heart Registry).

References

  • Marrugat J et al. Epidemiología de la cardiopatía isquémica en España: estimación del número de casos y de las tendencias entre 1997 y 2005. Rev Esp Cardiol. 2002; 55:337-346.
  • Marrugat J, D’Agostino R, Sullivan L, Elosua R, Wilson P, Ordovas J, et al. An adaptation of the Framingham coronary heart disease risk function to European Mediterranean areas. J Epidemiol Community Health. 2003;57:634-8.
  • Marrugat J, Solanas P, D’Agostino R, Sullivan L, Ordovas J, Cordon F, et al. Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada. Rev Esp Cardiol. 2003;56:253-61.
  • Marrugat J, Subirana I, Comín E, Cabezas C, Vila J, Elosua R, et al. Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA Study. J Epidemiol Community Health. 2007;61:40-7.
  • Grau M, et al. South-to-North gradient in lipid peroxidation in men with stable coronary artery disease in Europe. Eur Heart J. 2007;28:2841-2849.
  • Grau M, et al.Funciones de riesgo en la prevención primaria de las enfermedades cardiovasculares. Rev Esp Cardiol. 2008; 61: 404-16.
  • Estudio de mortalidad en España. Instituto de Salud Carlos III. [Consultado 04/01/2008]. Available at: http://193.146.50.130/raziel.php
  • Marrugat J, Elosua R, Aldasoro E, Tormo MJ, Vanaclocha H, Segura A et al. Regional variability in population acute myocardial infarction cumulative incidence and mortality rates in Spain 1997 and 1998. Eur J Epidemiol. 2004;19:831-9.
  • Grau M, Elosua R, Cabrera de León A, Guembe MJ, Baena-Díez JM, Vega Alonso T, et al. Factores de riesgo cardiovascular en España en la primera década del siglo XXI: Análisis agrupado con datos individuales de 11 estudios de base poblacional, Estudio DARIOS. Rev Esp Cardiol (in press)
  • Marrugat J, Sala J, Elosua R, Ramos R, Baena-Díez JM. Prevención cardiovascular: avances y el largo camino por recorrer. Rev Esp Cardiol. 2010; 63(Suppl 2): 49-54.
  • Grau M, Subirana I, Elosua R, Solanas P, Ramos R, Masiá R, et al. Trends in cardiovascular risk factor prevalence (1995-2000-2005) in northeastern Spain. Eur J Cardiovasc Prev Rehabil. 2007;14:653-9.
  • Grau M, Subirana I, Elosua R, Fitó M, Covas MI, Sala J et al. Why should population attributable fractions be periodically recalculated? An example from cardiovascular risk estimation in Southern Europe. Prev Med. 2010;51:78-84.
  • Marrugat J, Vila J, Baena-Díez JM, Grau M, Sala J, Ramos R, Subirana I, Fitó M, ElosuaR. Relative Validity of the 10-Year Cardiovascular Risk Estimate in a Population Cohort of the REGICOR Study. Rev Esp Cardiol. 2011;64:385-94.