09 rencontres biomédicale LIR Xavier Jouven

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

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09 rencontres biomédicale LIR Xavier Jouven

  1. 1. Cardiovascular Epidemiology INSERM U970 Cardiovascular epidemiology and sudden death 23/01/2010
  2. 2. Methodological difficulties myocardial infarction model additive treatment approach Cardiovascular epidemiology
  3. 3. <ul><li>Large data bases (10 000 to 1 million patients), </li></ul><ul><li>long follow-up (up to 30 years) </li></ul><ul><li>3C, PRIME, PPS, CARTAGENE </li></ul><ul><li>multiple international collaborations : </li></ul><ul><li>Boston, Seattle, Los Angeles, Rochester, Washington, Munich, Amsterdam, London, WHO MONICA </li></ul><ul><li>- Collaborations with industry </li></ul>Cardiovascular epidemiology: information
  4. 4. <ul><li>clinical trials, underexploited </li></ul><ul><li>Data mining, </li></ul><ul><li>Statistical analysis (CRO) unit labelled ISO 9001 </li></ul><ul><li>Senior epidemiological expertise </li></ul><ul><li>New approaches </li></ul>Statistical and epidemiological analysis
  5. 5. < 35 years: HCM, RVD, Brugada, myocardytis, congenital, ischemic >35 years: ischemic heart diseases 80%
  6. 6. Conventional approach : sudden death control New : sudden death M I approach control New question
  7. 7. Relationship between age of parent and age of progeny at time of sudden death
  8. 8. CARTAGENE    Cardiac ARresT And GENEtic Promotion Inserm Unit 970 : cardiovascular epidemiology and sudden death French German funding
  9. 9. CARTAGENE STUDY Kinetic of inclusion
  10. 10. HAPMAP (www.hapmap.org)
  11. 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. 12. Meta-analysis of chromosome 9p21 region and CAD
  13. 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
  15. 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
  16. 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

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