Epidemiology of ischaemic heart disease in France

Clémence Grave; Amélie Gabet; Nicolas Danchin; Marie-Christine Iliou; Grégory Lailler; Philippe Tuppin; Ariel Cohen; Jacques Blacher; Etienne Puymirat; Valérie Olié

doi:10.1016/j.acvd.2024.10.322

Epidemiology of ischaemic heart disease in France

Arch Cardiovasc Dis. 2024 Nov 9:S1875-2136(24)00668-5. doi: 10.1016/j.acvd.2024.10.322. Online ahead of print.

Authors

Affiliations

¹ Santé Publique France, 94410 Saint-Maurice, France. Electronic address: clemence.grave@santepubliquefrance.fr.
² Santé Publique France, 94410 Saint-Maurice, France.
³ Paris public hospitals (AP-HP), Georges-Pompidou European Hospital, 75015 Paris, France.
⁴ Saint Joseph Hospital, 75014 Paris, France.
⁵ National Health Insurance Fund (CNAM), 75020 Paris, France.
⁶ Paris public hospitals (AP-HP), Saint-Antoine Hospital, 75012 Paris, France.
⁷ Paris public hospitals (AP-HP), Hôtel-Dieu Hospital, 75004 Paris, France.

PMID: 39580344
DOI: 10.1016/j.acvd.2024.10.322

Abstract

Background: Cardiovascular disease is the leading cause of death worldwide. Ischaemic heart disease (IHD), including acute coronary syndromes (ACS) with or without ST-segment elevation and chronic coronary syndromes, is one of the main causes.

Aim: To describe the epidemiology of IHD in France in 2022.

Methods: Adults hospitalized due to IHD in 2022 were identified in the French National Health Data System. The characteristics, hospital management and one-year outcomes of patients were described. The IHD prevalence among people alive on 01.01.23 was estimated by combining previous hospitalizations and people in receipt of 100% coverage for a registered long-term disease. IHD-related mortality was estimated from death certificates.

Results: In 2022, 242,227 adults were hospitalized for IHD in France (452/100,000 person-years); 2.98 million prevalent cases of IHD (5.6% of the adult population) and 31,391 IHD-related deaths (4.8% of all deaths) were recorded. The average age at hospitalization for IHD was 69.3years and 29.0% of patients were women. Exposure to cardiovascular risk factors was high. The average length of hospitalization was 4.9 days, 55.9% had undergone a percutaneous coronary intervention and 4.5% a coronary artery bypass graft. The in-hospital death rate was 3.6%. Six months after the index hospitalization, 22.0% of patients had been admitted to a rehabilitation service (42.9% for STE-ACS). In the year following the index hospitalization, 84.5% of patients had received antiplatelet drugs, 82.6% a statin, 68.8% a beta-blocker and 67.7% a renin-angiotensin-aldosterone system treatment. One year after index hospitalization, the rate of rehospitalization for IHD was 29.9% and the rate of all-cause death was 9.3%.

Conclusions: The burden of IHD remains high in France. These results suggest that primary prevention of IHD should be maintained and improved, as well as secondary prevention, to improve the prognosis and quality of life of the 3 million patients with coronary disease.

Keywords: Epidemiology; Hospitalization; Ischaemic heart disease; Outcomes; Prevalence.