0053: Incidence of cardiovascular events following myocardial infarction in France: an observational analysis using a claims database

Abstract

To describe the characteristics and treatments of patients having a myocardial infarction (MI) and estimate the incidence of cardiovascular events following the index MI, in the French Health Insurance database. A cohort of patients who had a MI in France between 2007 and 2011 was extracted from a claim database: the Echantillon Généraliste de Bénéficiaires (a 1% representative sample of subjects covered by the general health insurance (?600,000 patients). The incidence of cardiovascular events following the index MI was estimated using the Kaplan Meier method. 1,977 subjects were identified with an index myocardial MI: 2/3 were males, mean age=67.2 y, 20.6% had diabetes, 37.6% hypercholesterolemia and 82.4% hypertension. Cumulative incidence rates for outcomes are shown in the table. All cause mortality at 3 years (including in-hospital death) was 27% (95% CI: 25.8-29.1). This incidence was high in the 3 months following the index MI stabilized thereafter. Despite high prescription rates of post-MI treatments, rates of all-cause mortality and CV events remained high following MI. This underscores the need to improve secondary prevention. Abstratct 0053 – Table % patients treated 6 months before index MI 6 months after index MI Statins 30.7% 91.1% Ezetimibe 3.6% 4.9% Aspirine (Alone) 59.9% 11.6% Aspirine+P2Y12-I * 23.9% 76.0% Class III Antiarrhytmic 2.4% 8.4% Oral Anticoagulant 5.1% 10.1% Non-Thiazide Diuretics 19.1% 32.9% ACE Inhibitors 18.6% 71.0% Beta-Blockers 26.5% 86.0% Nitrates 9.9% 46.4% Other Antihypertensives ** 40.2% 30.3% Cumulative incidence rate (95%CI) 1 year 2 year 3 year All cause deaths *** 17.8% (16.0%;19.5%) 21.6% (20.7%;23.5%) 27.0% (25.8%;29.1%) Recurrent MI 3.1% (2.3%;3.8%) 4.1% (3.2%;5.0%) 4,7% (3.7%;5.7%) Stroke orTIA 1.9% (1.3%;2.5%) 3.1% (2.3%;3.9%) 4.1% (3.1%;5.0%) Composite of death *** / reinfarction/stroke 20.7% (18.9%;22.5%) 26.0% (24.0%;28.0%) 32.1% (29.8%;34.3%) * mostly clopidogrel ** thiazide diuretics, angiotensin II receptor blockers, CCBs *** including in-hospital deaths