09 rencontres biomédicale LIR Xavier Jouven

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2ND INTERNATIONAL RESEARCH MEETING …

2ND INTERNATIONAL RESEARCH MEETING
4 JUNE 2010- HÔTEL DE MARIGNY PARIS

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  • 1. Cardiovascular Epidemiology INSERM U970 Cardiovascular epidemiology and sudden death 23/01/2010
  • 2. Methodological difficulties myocardial infarction model additive treatment approach Cardiovascular epidemiology
  • 3.
    • Large data bases (10 000 to 1 million patients),
    • long follow-up (up to 30 years)
    • 3C, PRIME, PPS, CARTAGENE
    • multiple international collaborations :
    • Boston, Seattle, Los Angeles, Rochester, Washington, Munich, Amsterdam, London, WHO MONICA
    • - Collaborations with industry
    Cardiovascular epidemiology: information
  • 4.
    • clinical trials, underexploited
    • Data mining,
    • Statistical analysis (CRO) unit labelled ISO 9001
    • Senior epidemiological expertise
    • New approaches
    Statistical and epidemiological analysis
  • 5. < 35 years: HCM, RVD, Brugada, myocardytis, congenital, ischemic >35 years: ischemic heart diseases 80%
  • 6. Conventional approach : sudden death control New : sudden death M I approach control New question
  • 7. Relationship between age of parent and age of progeny at time of sudden death
  • 8. CARTAGENE    Cardiac ARresT And GENEtic Promotion Inserm Unit 970 : cardiovascular epidemiology and sudden death French German funding
  • 9. CARTAGENE STUDY Kinetic of inclusion
  • 10. HAPMAP (www.hapmap.org)
  • 11. Wellcome Trust Case-Control Consortium. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls . Nature 2007 447:661-678 No associated marker Several associated markers
  • 12. Meta-analysis of chromosome 9p21 region and CAD
  • 13. GHS - The loci affecting CDKN2B expression and CAD on chromosome 9p21 are independent. In green : genotyped SNPs; green triangle : CAD SNP, rs10757272 ; red curve :–log10( P -value) for the association between SNPs and CDKN2B expression. The LD between pairs of SNPs is shown at the bottom of the figure: white (r 2 =0) and black (r 2 =1). The CDKN2B and CAD-associated SNPs are located in different blocks of LD strongly suggesting that the genetic effects on CDKN2B expression and CAD are independent. (WGAViewer:http://people.genome.duke.edu/~dg48/WGAViewer/)
  • 14.  
  • 15. Relation between life expectancy and heart rate 1 10 100 1000 0 10 20 30 40 50 60 70 80 90 Life expectancy, years Heart rate, bpm Man Other mammals Mouse Hampster Rat Monkey Marmot Dog Cat Tiger Giraffe Ass Horse Lion Elephant Whale
  • 16. Relation between life expectancy and heart rate 2000 1950 1900 1850 1800 1750 1 10 100 1000 0 10 20 30 40 50 60 70 80 90 Life expectancy, years Heart rate, bpm Man Other mammals Mouse Hampster Rat Monkey Marmot Dog Cat Tiger Giraffe Ass Horse Lion Elephant Whale
  • 17. EXPRESD Paris University Infant sudden death Mobile medical emergency units Resuscitation SOCIAL- ETHICAL ISSUES PSYCHOLOGY RESEARCH EPIDEMIOLOGY GENETIC CLINIC Intensive care units Electro physiology MEDICO LEGAL FAMILIAL SCREENING CPR TEACHERS (STAPS) Workshops, TEACHING: PHYSICIEN, PHARMACISTS ETC MEDICO ECONOMIC chaire sudden death Fondation Paris Descartes     European eXcellence center for PREvention of Sudden Death Transdisciplinary approach