Key result
Between 2009 and 2014 in France, hospital admissions for myocardial infarction and percutaneous coronary interventions increased by nearly 25%, while overall in-hospital mortality decreased by 15% to 3.3%.
Why the study?
Despite declining mortality rates, the burden of coronary artery disease remains significant, and rising modifiable risk factors have further increased this epidemic.
Observational (n=678,021)
Yes
The hospital burden of coronary artery disease in France increased significantly from 2009 to 2014, driven by rising acute myocardial infarction admissions, particularly among young women, despite a concurrent decrease in in-hospital mortality.
Rising MI admissions signal growing CAD burden in France; leaves open whether trends reflect incidence changes or artifacts, warranting prospective validation.
BACKGROUND: Currently, cardiovascular disease (CVD) is widely acknowledged to be the first leading cause of fatality in the world with 31% of all deaths worldwide and is predicted to remain as such in 2030. Furthermore, CVD is also a major cause of morbidity in adults worldwide. Among these diseases, the coronary artery disease (CAD) is the most common cause, accounting for over 40% of CVD deaths. Despite a decline in mortality rates, the consequences of more effective preventive and management programs, the burden of CAD remains significant. Indeed, the rise in the prevalence of modifiable risk factors due to changes in lifestyle and health behaviors has further increased the burden of this epidemic. Our objective was to evaluate the hospital burden of CAD via MI trends and Percutaneous Coronary Intervention (PCI) in the French Prospective Payment System (PPS). METHODS: MI/PCI were identified in the national PPS database from 2009 to 2014 for patients aged 20 to 99, living in metropolitan France. We examined hospitalisation, readmission and mortality trends using standardised rates. RESULTS: Over the six-year period, we identified 678,021 patients, representing 900,121 stays of which, 215,224 had a MI and a PCI. Admission trends increased by nearly 25%. Acute MI cases increased every year, with an alarming increase in women, and more specifically in young women. Men were 3 times more hospitalised than women, who were older. A North-South divide was noted. Twenty seven percent of patients experienced readmission within 1 month. Trajectories of care were significantly different by sex and age. Overall in-hospital death was 3.3%, decreasing by 15% during the period. The highest adjusted mortality rates were observed for inpatients aged <40 or >80. CONCLUSION: We outlined the public health burden of this condition and the importance of improving the trajectories of care as an aid for better care.
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Pinaire et al. (2019) conducted an observational in Coronary artery disease (Myocardial Infarction and/or Percutaneous Coronary Intervention) (n=678,021). Time period (2009-2014) was evaluated on Hospital admission trends for MI/PCI. Between 2009 and 2014 in France, hospital admissions for myocardial infarction and percutaneous coronary interventions increased by nearly 25%, while overall in-hospital mortality decreased by 15% to 3.3%.
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