{"id":7869,"date":"2026-08-20T14:11:20","date_gmt":"2026-08-20T12:11:20","guid":{"rendered":"https:\/\/parlonstechs.com\/all\/?p=7869"},"modified":"2026-08-20T14:11:20","modified_gmt":"2026-08-20T12:11:20","slug":"contrairement-a-ce-quon-pense-les-infarctus-surviendraient-tres-rarement-sans-signal-prealable","status":"publish","type":"post","link":"https:\/\/parlonstechs.com\/all\/2026\/08\/20\/contrairement-a-ce-quon-pense-les-infarctus-surviendraient-tres-rarement-sans-signal-prealable\/","title":{"rendered":"Contrairement \u00e0 ce qu&rsquo;on pense, les infarctus surviendraient tr\u00e8s rarement sans signal pr\u00e9alable"},"content":{"rendered":"<p><img decoding=\"async\" src=\"https:\/\/cdn8.futura-sciences.com\/a1280\/images\/infarctus-avc-hypertension-femmes.png\" alt=\"Infarctus et AVC : quatre facteurs de risque pr\u00e9c\u00e9deraient 99 % des accidents cardiovasculaires. \u00a9&amp;nbsp;Jacob Wackerhausen, iStock\" \/><\/p>\n<h2>99 % des infarctus et des AVC survenus dans une cohorte de plus de neuf millions d&rsquo;adultes ont \u00e9t\u00e9 pr\u00e9c\u00e9d\u00e9s d&rsquo;au moins un facteur de risque parmi quatre. L&rsquo;id\u00e9e d&rsquo;un accident cardiaque qui frappe sans pr\u00e9venir en sort \u00e9branl\u00e9e. Une autre \u00e9tude nuance toutefois le tableau, en particulier chez les femmes.<\/h2>\n<p>Les donn\u00e9es de sant\u00e9 de plus de neuf millions d&rsquo;adultes en Cor\u00e9e du Sud et aux \u00c9tats-Unis convergent vers un constat net : la quasi-totalit\u00e9 des personnes ayant subi un \u00e9v\u00e9nement cardiovasculaire majeur pr\u00e9sentaient auparavant au moins un facteur de risque identifiable. Quatre suffisent \u00e0 couvrir presque tous les cas.<\/p>\n<p>&nbsp;<\/p>\n<h2>Quatre facteurs, 99 % des \u00e9v\u00e9nements<\/h2>\n<p>Les quatre marqueurs en question sont l&rsquo;hypertension art\u00e9rielle, un taux de cholest\u00e9rol \u00e9lev\u00e9, une glyc\u00e9mie \u00e9lev\u00e9e et le tabagisme, actuel ou pass\u00e9. Pris ensemble, ils ont pr\u00e9c\u00e9d\u00e9 99 % des \u00e9v\u00e9nements cardiovasculaires enregistr\u00e9s au cours de cette \u00e9tude de long terme, publi\u00e9e en 2025.<\/p>\n<p>Le r\u00e9sultat tient m\u00eame dans le groupe le moins expos\u00e9. Chez\u00a0les femmes\u00a0de moins de 60 ans, plus de 95 % des infarctus et des accidents vasculaires c\u00e9r\u00e9braux \u00e9taient associ\u00e9s \u00e0 l&rsquo;un de ces facteurs pr\u00e9existants.<\/p>\n<p>&nbsp;<\/p>\n<h2>L&rsquo;hypertension en t\u00eate<\/h2>\n<p>Un facteur domine largement. Dans les deux pays, plus de 93 % des personnes ayant subi un infarctus, un\u00a0<span class=\"definition loaded bottom-popup\" aria-describedby=\"medecine-accident-vasculaire-cerebral\" data-definition=\"2455\">AVC<\/span>\u00a0ou une\u00a0insuffisance cardiaque\u00a0pr\u00e9sentaient une\u00a0<span class=\"definition\" aria-describedby=\"medecine-hypertension-arterielle\" data-definition=\"7323\">hypertension<\/span>\u00a0au pr\u00e9alable.<\/p>\n<p>La prise en charge de la\u00a0<span class=\"definition\" aria-describedby=\"medecine-tension-arterielle\" data-definition=\"7321\">pression art\u00e9rielle<\/span>\u00a0appara\u00eet de ce fait comme un levier central de\u00a0<span class=\"definition\" aria-describedby=\"developpement-durable-prevention\" data-definition=\"6509\">pr\u00e9vention<\/span>.<\/p>\n<p><a title=\"Presque tout le monde pr\u00e9sente au moins un facteur de risque avant un infarctus, un AVC ou une insuffisance cardiaque\" href=\"https:\/\/news.northwestern.edu\/stories\/2025\/09\/nearly-everyone-has-at-least-one-risk-factor-before-a-heart-attack-stroke-or-heart-failure\" target=\"_blank\" rel=\"noopener\">Philip Greenland<\/a>,\u00a0<span class=\"metier\" aria-describedby=\"metiers-cardiologue\" data-metier=\"156\">cardiologue<\/span>\u00a0\u00e0 l&rsquo;universit\u00e9 Northwestern et auteur principal, estime que l&rsquo;\u00e9tude, publi\u00e9e dans le\u00a0<em><a title=\"Causes d&#039;infarctus du myocarde chez les patients plus jeunes : \u00e9l\u00e9vation de la troponine chez les personnes de 65 ans et moins dans le comt\u00e9 d&#039;Olmsted\" href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2025.07.012\" target=\"_blank\" rel=\"noopener\">Journal of the American College of Cardiology<\/a>\u00a0<\/em>(JACC), d\u00e9montre de fa\u00e7on convaincante que l&rsquo;exposition \u00e0 un ou plusieurs facteurs non optimaux pr\u00e9c\u00e8de la quasi-totalit\u00e9 de ces accidents. L&rsquo;enjeu consiste selon lui \u00e0 concentrer les efforts sur ces facteurs modifiables, plut\u00f4t que de se disperser vers des param\u00e8tres difficilement traitables et dont le r\u00f4le causal n&rsquo;est pas \u00e9tabli.<\/p>\n<p>Une pr\u00e9cision importante \u00e9claire ce chiffre de 99 %. Les auteurs ne comptabilisent pas uniquement les diagnostics pos\u00e9s, mais les niveaux consid\u00e9r\u00e9s comme non optimaux, y compris ceux situ\u00e9s sous le seuil clinique. Ce p\u00e9rim\u00e8tre \u00e9largi explique en partie l&rsquo;ampleur du r\u00e9sultat.<\/p>\n<p>&nbsp;<\/p>\n<p>Ces travaux contredisent l&rsquo;id\u00e9e, avanc\u00e9e r\u00e9cemment, d&rsquo;une augmentation des accidents cardiovasculaires survenant en l&rsquo;absence de tout facteur de risque. Selon les auteurs, les \u00e9tudes ant\u00e9rieures auraient manqu\u00e9 certains diagnostics ou n\u00e9glig\u00e9 des niveaux inf\u00e9rieurs au seuil de diagnostic.<\/p>\n<p>Dans un \u00e9ditorial accompagnant la publication, Neha Pagidipati, cardiologue \u00e0 l&rsquo;universit\u00e9 Duke et non impliqu\u00e9e dans l&rsquo;\u00e9tude, souligne l&rsquo;importance de traiter ces risques avant qu&rsquo;ils ne d\u00e9bouchent sur des cons\u00e9quences graves. Elle estime qu&rsquo;il est possible, et n\u00e9cessaire, de faire mieux.<\/p>\n<p>&nbsp;<\/p>\n<h2>Chez les femmes, d&rsquo;autres m\u00e9canismes en cause<\/h2>\n<p>Un second travail, publi\u00e9 dans les\u00a0<a title=\"Populations \u00e2g\u00e9es : Impact du tabagisme et de l\u2019alimentation et pr\u00e9valence de la polym\u00e9dication \u2014 Limelight, septembre 2025\" href=\"https:\/\/www.mayoclinicproceedings.org\/article\/S0025-6196(25)00415-X\/fulltext\" target=\"_blank\" rel=\"noopener\"><em>Mayo clinic proceedings<\/em><\/a>,\u00a0en septembre 2025 par des chercheurs de la\u00a0<em>Mayo Clinic<\/em>, apporte un \u00e9clairage compl\u00e9mentaire, en s&rsquo;int\u00e9ressant non plus aux facteurs de risque mais aux causes imm\u00e9diates.<\/p>\n<p>L&rsquo;\u00e9quipe a analys\u00e9 1 474 infarctus survenus chez des personnes de 65 ans ou moins, enregistr\u00e9s entre 2003 et 2018 dans le comt\u00e9 d&rsquo;Olmsted, au Minnesota. L&rsquo;examen des dossiers m\u00e9dicaux et de l&rsquo;imagerie a permis d&rsquo;identifier une cause principale pour chaque cas.<\/p>\n<p>Traditionnellement, l&rsquo;infarctus est attribu\u00e9 \u00e0 l&rsquo;ath\u00e9rothrombose, c&rsquo;est-\u00e0-dire la formation d&rsquo;un\u00a0caillot\u00a0sur une\u00a0<span class=\"definition\" aria-describedby=\"medecine-artere\" data-definition=\"3017\">art\u00e8re<\/span>\u00a0obstru\u00e9e par des d\u00e9p\u00f4ts, qui bloque l&rsquo;<span class=\"definition loaded\" aria-describedby=\"developpement-durable-irrigation\" data-definition=\"11290\">irrigation<\/span>\u00a0du c\u0153ur.<\/p>\n<p>Ce m\u00e9canisme explique effectivement 75 % des infarctus chez les hommes. Chez les femmes, il ne rend compte que de 47 % des cas. Plus de la moiti\u00e9 des infarctus f\u00e9minins rel\u00e8vent donc d&rsquo;autres causes.<\/p>\n<p>&nbsp;<\/p>\n<p>Chez les femmes, 34 % des \u00e9v\u00e9nements correspondent \u00e0 un d\u00e9s\u00e9quilibre entre les besoins du c\u0153ur en oxyg\u00e8ne et ce qui lui est apport\u00e9, provoqu\u00e9 par une contrainte ext\u00e9rieure comme une\u00a0<span class=\"definition loaded bottom-popup\" aria-describedby=\"medecine-anemie\" data-definition=\"652\">an\u00e9mie<\/span>\u00a0ou une infection. Les cardiologues parlent d&rsquo;infarctus de type 2.<\/p>\n<p>D&rsquo;autres m\u00e9canismes contribuent significativement au tableau, notamment les dissections coronaires spontan\u00e9es, ces d\u00e9chirures de la paroi art\u00e9rielle o\u00f9 le sang s&rsquo;accumule, et les\u00a0<span class=\"definition\" aria-describedby=\"medecine-embolie\" data-definition=\"2671\">embolies<\/span>, caus\u00e9es par des\u00a0<span class=\"definition\" aria-describedby=\"medecine-caillot\" data-definition=\"12120\">caillots<\/span>\u00a0venus d&rsquo;ailleurs dans l&rsquo;organisme.<\/p>\n<p>Claire Raphael, cardiologue, souligne que ces causes ont longtemps \u00e9t\u00e9 sous-identifi\u00e9es, particuli\u00e8rement chez les femmes. Lorsque l&rsquo;origine r\u00e9elle d&rsquo;un\u00a0infarctus\u00a0est mal comprise, les traitements administr\u00e9s perdent en efficacit\u00e9, voire deviennent nocifs. Comprendre pourquoi l&rsquo;accident est survenu compterait autant que le traiter, et d\u00e9terminerait la fronti\u00e8re entre\u00a0<span class=\"definition\" aria-describedby=\"medecine-guerison\" data-definition=\"2707\">gu\u00e9rison<\/span>\u00a0et\u00a0<span class=\"definition\" aria-describedby=\"medecine-recidive\" data-definition=\"2833\">r\u00e9cidive<\/span>.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>Ce que ces r\u00e9sultats impliquent<\/h2>\n<p>Les deux \u00e9tudes reposent sur des donn\u00e9es observationnelles. Elles \u00e9tablissent des associations \u00e0 l&rsquo;\u00e9chelle de larges populations et ne permettent pas de conclure \u00e0 une causalit\u00e9 pour un individu donn\u00e9.<\/p>\n<p>Leur port\u00e9e pratique tient ailleurs : les quatre facteurs identifi\u00e9s sont tous modifiables, par le suivi m\u00e9dical, le traitement ou\u00a0l&rsquo;arr\u00eat du tabac. Et l&rsquo;existence de m\u00e9canismes distincts selon le sexe plaide pour une attention accrue au diagnostic chez les femmes.<\/p>\n<p>Ces informations ont une vis\u00e9e g\u00e9n\u00e9rale et ne remplacent pas un avis m\u00e9dical. Le\u00a0<span class=\"definition\" aria-describedby=\"medecine-depistage\" data-definition=\"2659\">d\u00e9pistage<\/span>\u00a0de l&rsquo;hypertension, du cholest\u00e9rol et de la glyc\u00e9mie rel\u00e8ve du m\u00e9decin traitant, qui peut \u00e9valuer le risque individuel et proposer un suivi adapt\u00e9. En pr\u00e9sence de signes \u00e9vocateurs d&rsquo;un infarctus ou d&rsquo;un AVC, notamment une\u00a0<span class=\"definition\" aria-describedby=\"medecine-douleur\" data-definition=\"17039\">douleur<\/span>\u00a0thoracique, une g\u00eane respiratoire, une faiblesse soudaine d&rsquo;un c\u00f4t\u00e9 du corps ou un trouble de la parole, il faut appeler imm\u00e9diatement le 15 ou le 112.<\/p>\n<p>via futura<\/p>\n","protected":false},"excerpt":{"rendered":"<p>99 % des infarctus et des AVC survenus dans une cohorte de plus de neuf millions d&rsquo;adultes ont \u00e9t\u00e9 pr\u00e9c\u00e9d\u00e9s d&rsquo;au moins un facteur de risque parmi quatre. L&rsquo;id\u00e9e d&rsquo;un [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7870,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21,229,18],"tags":[],"class_list":["post-7869","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualite","category-sante","category-sciences"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Contrairement \u00e0 ce qu&#039;on pense, les infarctus surviendraient tr\u00e8s rarement sans signal pr\u00e9alable - Parlons Techs - Store<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/parlonstechs.com\/all\/2026\/08\/20\/contrairement-a-ce-quon-pense-les-infarctus-surviendraient-tres-rarement-sans-signal-prealable\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Contrairement \u00e0 ce qu&#039;on pense, les infarctus surviendraient tr\u00e8s rarement sans signal pr\u00e9alable - Parlons Techs - Store\" \/>\n<meta property=\"og:description\" content=\"99 % des infarctus et des AVC survenus dans une cohorte de plus de neuf millions d&rsquo;adultes ont \u00e9t\u00e9 pr\u00e9c\u00e9d\u00e9s d&rsquo;au moins un facteur de risque parmi quatre. 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