A global killer

Coronary Artery Disease (CAD) is the most common type of heart disease. Globally, CAD is the leading cause of death and is predicted to remain so for the next 20 years.1
Each year, approximately 3.8 million men and 3.4 million women die from CAD.2 In 2020, it is estimated that this disease will be responsible for a total of 11.1 million deaths globally.1

  • Someone suffers a coronary event every 26 seconds, and someone dies from one every minute in the USA. 3
  • In Europe, between 1 in 5 and 1 in 7 European women die from CAD, and the disease accounts for between 16% and 25% of all deaths in European men.6

An international epidemic

Due to this increasing incidence across the world CAD has been described as an epidemic.6

  • Studies suggest that the average age-adjusted incidence rates of CAD per 1 000 person-years are 12.5 for white men, 10.6 for black men, and 4.0 for white women.7
  • According to the American Heart Association (AHA) statistics, 770,000 Americans suffered a new coronary attack in 2008, and a further 430,000 experienced a recurrent attack.3 An additional 190 000 silent first heart attacks are estimated to occur each year.3

High cost burden

In addition to its mortality burden, CAD is a leading cause of morbidity and loss of quality of life. This makes CAD a major public health problem which exerts heavy economic costs. Overall, CAD is estimated to have cost the EU €45 billion in 2003.8

  • Approximately 1 million working years were lost because of CAD mortality, with a total cost of €11.7 billion.
  • An additional 90 million working days were lost because of CAD morbidity.8

Causes and consequences of CAD

In CAD, the coronary arteries that supply oxygen-rich blood to the heart muscle become hard and narrow as a result of atherosclerosis – a build-up of cholesterol and plaque on the inner artery walls. These fatty deposits reduce blood flow to the heart muscle, depriving it of essential oxygen.9,10

The insufficient supply of oxygen to the heart muscle which results from CAD can cause symptoms of chest pain and discomfort known as angina. These brief episodes of oxygen deprivation and angina occur when the lumen of the artery narrows by 65% to 75%.6 In more severe cases of CAD where the coronary artery becomes completely blocked, a whole section of the heart muscle can be deprived of oxygen and die.9 The result is a heart attack (also known as a myocardial infarction). Most heart attacks occur when a blood clot forms in the coronary artery, cutting off the blood supply and causing permanent heart damage.9 The atherosclerosis associated with CAD increases the risk of these arterial blood clots.10 Over time, CAD can lead to both heart failure and heart rhythm disorders (arrhythmias).

References:

1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442.
2. WHO. The global burden of disease: 2004 update. Available at: www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html.
3. Heart Disease and Stroke Statistics–2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009;119:e21-e181.
4. Heron MP, Hoyert DL, Xu J, Scott C, Tejada-Vera B. Deaths: preliminary data for 2006. Natl Vital Stat Rep. 2008;56:1-52.
5. Rea TD, Pearce RM, Raghunathan TE, et al. Incidence of out-of hospital cardiac arrest. Am J Cardiol. 2004;93:1455-1460.
6. The CLARIFY Registry: Management of Stable Coronary Artery Disease in Clinical Practice. Brochure for participating doctors. Edited by G Steg on behalf of the BEAUTIFUL Executive Committee.
7. Jones DW, Chambless LE, Folsom AR, Heiss G, Hutchinson RG, Sharrett AR, Szklo M, Taylor HA Jr. Risk factors for coronary heart disease in African Americans: the Atherosclerotic Risk in Communities Study, 1987–1997. Arch Intern Med. 2002;162:2565–2571.
8. Leal J, Luengo-Fernández R, Gray A, Petersen S, Rayner M. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006;27:1610-1619.
9. MedlinePlus. Coronary Artery Disease. Available at: http://www.nlm.nih.gov/medlineplus/coronaryarterydisease.html
10. National Heart Lung and Blood Institute. Coronary Artery Disease. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_WhatIs.html