previous next contents

POL-WAR: Warsaw Contributors from the MPC: Grazyna Broda and Pawel Kurjata

© National Institute for Health and Welfare and the MORGAM Project investigators Last updated: 26 April 2005 For more information, please contact Kari Kuulasmaa (firstname.lastname@thl.fi)

Contents

• Cohort identification
• Cohort recruitment and the baseline examination
• End-points followed up
• End of follow-up period
• Follow-up procedures
• Diagnostic procedures
  • at baseline
  • during follow-up
• References

Cohort identification

• Country: Poland
• MPC: 36 - Warsaw
  • Administrative centre: National Institute of Cardiology, Warsaw, Poland
  • Key personnel: Grazyna Broda (Principal Investigator), Pawel Kurjata, Stefan L Rywik, Danuta Szczesniewska, Maria Polakowska, Aleksandra Pytlak, Walerian Piotrowski
• RUs: The two RUs are administrative districts of Warsaw right bank of Vistula. Urban, car and pharmaceutical industries, small businesses, administration. Above-average risk factor levels and cardiovascular disease mortality is increasing.
  • 01 - Warsaw Praga South.
  • 02 - Warsaw Praga North
• RUAs
  • POL-WARa: combining RUs 01 and 02
• Cohorts:
  • Cohort 01: Respondents of representative samples of 35-64 years old men and women of the RUs. The baseline survey carried out in 1983-85.
  • Cohort 02: Respondents of representative samples of 35-64 years old men and women of the RUs. The baseline survey carried out in 1988-89.
  • Cohort 03: Respondents of representative samples of 35-64 years old men and women of the RUs. The baseline survey carried out in 1993.

Cohort recruitment and the baseline examination

The cohorts were formed by the respondents of representative sample surveys of the RUs. Electoral register was used as the sampling frame for the single stage sampling, which was stratified by sex and 10-year age group. The baseline examinations were carried out as part of the WHO MONICA Project.

The size of the MORGAM cohorts and the response rates of the population surveys from which the cohorts were derived are:

DNA are not available for the cohorts.

End-points followed up

• Deaths: yes
• Non-fatal acute MI: yes
• Unstable angina pectoris: no
• Silent MI: no
• Cardiac revascularization: no
• Stable angina pectoris: no
• Non-fatal stroke events: yes
• Thromboembolic events: no

End of follow-up period

• Fatal events: 31 December 1998
• Non-fatal events: 31 December 1994 with upper age limit of 64 years.

Follow-up procedures

Sources of data

• Polish Universal Electronic Population Register (PESEL): The Department of State Registers,  Ministry of Interior and Administration (Departament Rejestrow Panstwowych Ministerstwa Spraw Wewnetrznych i Administracji) maintains the Polish Universal Electronic Population Register (PESEL).  The register system was established in 1979. It covers all residents of Poland. It includes the person's given name(s), surname, family name, parents' first names and mother's family name, date and place of birth, gender, citizenship, address, ID card number, year of emigration and date of death. The people are identified using the unique 11-character PESEL number. Each permanent resident of Poland has a unique 11-digit PESEL number (given by PESEL System Office). The PESEL number includes date of birth, code of sex, ordinal number and check digit. The PESEL number is different from the ID card number. [1].
• Central Death Register: Central Statistical Office keeps the Central Death Register, which includes the causes of death based on death certificates issued by physicians. The register covers all deaths in Poland. The register does not include data on deaths occurring abroad.
• MONICA Coronary and Stroke Registers: These were population based registers taking part in the WHO MONICA Project. The coronary and stroke event registers covered RUs 01 and 02 in years 1983-1994. Its upper age limit was 64 years [2, 3, 4].

Procedures

The PESEL numbers were recorded for all members of the cohorts and all records in the MONICA Coronary and Stroke Register. Using the unique PESEL numbers the cohorts were linked to:

1. PESEL register to establish vital status and date of death or emigration;
2. Central Death Register to establish cause of death;
3. MONICA Coronary and Stroke Registers to identify events.

Hence, the follow-up for deaths covered the whole country and all age groups, whereas the follow-up for non-fatal coronary and stroke events covered only events that occurred to residents of the RUs whose age was less than 65 years on or before 31 December 1994.

Diagnostic procedures

At baseline:

• History of MI:
  • Documented: data not available
  • Self-reported: data not available
  • ECG: Persons with Minnesota code 1-1 or 1-2 (except 1-2-6) in baseline ECG were considered having an ECG change indicating myocardial infarction.
  • Rose questionnaire: As specified in item HISMI4 of MORGAM Form 21
• History of cardiac revascularisation:
  • Documented: data not available
  • Self-reported: data not available
• History of angina pectoris:
  • Documented: data not available
  • Rose questionnaire: As specified in item HISAP2 of MORGAM Form 21
  • Self-reported: data not available
• History of coronary heart disease, type unspecified: An affirmative answer to the question "Have you ever had a heart attack (diagnosed as myocardial infarction, coronary artery disease, acute or chronic coronary insufficiency or ischemic heart disease)?" was considered as history of coronary heart disease, type unspecified.
• History of stroke:
  • Documented: data not available
  • Self-reported: An affirmative answer to the question "Have you ever been told by a doctor that you had a stroke or brain ischemia in the past?" was considered as self-reported history of stroke.
• History of Diabetes: An affirmative answer to the question "Have you ever had diabetes?" was considered as history of diabetes.

During follow-up:

• Deaths: Final official cause of death codes from the Central Death Register were used for the  relevant items of MORGAM Form 25.
• CHD events: For fatal and non-fatal events found in the MONICA Coronary Register, the MONICA diagnostic category was used. For deaths which were found in the Central Death Register, but not in the MONICA Coronary Register, the diagnostic classification was done using the ICD-code of the underlying cause of death:

  Underlying cause of death code		MORGAM DGNCAT
  ICD-9	ICD-10
  410-414	I21-I25	3
  440, 798	I46, I70, R96, R98, R99	5
  Other than above codes	Other than above codes	7

  Coronary events occurring within 28 days of each other were considered as one event. If several diagnoses were given during a 28-days period the most severe event was used for the classification.

  A non-fatal possible MI following a possible or definite MI was not recorded for MORGAM. The same concerns a non-fatal definite MI following a definite MI.

• Stroke events: For fatal and non-fatal stroke events found in the MONICA Stroke Register, the MONICA diagnostic category was used. For deaths which were found in the Central Death Register, but not in the MONICA Stroke Register, the diagnostic classification was done using the ICD-code of the underlying cause of death:

  Underlying cause of death code accepted as stroke		MORGAM DGNCAT
  ICD-9	ICD-10
  430, 431, 433, 434, 436	I60, I61, I63, I64	9
  Other than above codes	Other than above codes	4

  A non-fatal definite stroke following a definite stroke was not recorded for MORGAM.

References

1. Polish Universal Electronic Population Register (PESEL) http://www.mswia.gov.pl/crp_pesel.html in Polish only.
2. Tunstall-Pedoe H, editor. Prepared by Tunstall-Pedoe H, Kuulasmaa K, Tolonen H, Davidson M, Mendis S with 64 other contributors for The WHO MONICA Project. MONICA Monograph and Multimedia Sourcebook. Geneva: World Health Organization; 2003. ISBN 92 4 156223 4.
3. Rywik S. Sznajd J. Wagrowska H. Malczewska-Malec M. Kurjata P. Idzior-Walus B. Przestalska-Malkin H. Misiowiec P. Kuzminska A. Mizera R. et al. Monitoring trends in cardiovascular disease incidence and mortality and their determinants: "Pol-Monica" longitudinal study. IV. Myocardial infarction register--methodology and application. Przegl Lek. 1985; 42(2):287-98 (Polish).
4. Rywik S. Sznajd J. Kurjata P. Ciszkiewicz-Zeman U. Przestalska-Malkin H. Malczewska-Malec M. Wagrowska H. Misiowiec P. Magdon M. Trznadel I. et al. Monitoring trends in cardiovascular disease incidence and mortality and their determinants: "Pol-Monica" longitudinal study. V. Stroke register--methodology and application. Przegl Lek. 1985; 42(2):299-304 (Polish).

previous next contents