274 Comparative analysis of patients with acute coronary and cerebrovascular syndromes from the national French hospitalisation heath care system database

Abstract

To compare vascular risk factor profiles and early outcomes in all French patients hospitalized for either acute coronary (ACS), or cerebrovascular syndromes (CVS), or both, between 2005 and 2008. All French hospitals. Retrospective analysis. National database called “Hospital Discharge Diagnosis Records”. Number and annual rates, vascular risk factors, and early outcome of hospitalized patients for a unique stay for ACS or CVS or for both ACV and CVS in a 2-month time window. Over the 4-year study-period, 1,189,043 patients were hospitalized for CVS and/or ACS. Among these, 638,061 (53.7%) had CVS alone, 525,419 (44.3%) had ACS alone, and 24,163 (2%) had both. Patients of the latter group were older (75.2 ± 12 years), and had a higher prevalence of hypertension (50.8%), diabetes (26.3%), and atrial fibrillation (23.9%) (p<0.001). In contrast, the prevalence of obesity (9.6%) and hypercholesterolemia (25.7%) was greater in ACS only patients. Patients with both CVS and ACS had a longer length of stay (16.1 days), and were less likely to be discharged to home. These patients also had a higher in-hospital risk of death, in men and in women (Figure). This risk remained after adjustment for age, sex, and vascular risk factors compared with patients with either CVS alone (OR = 1.71, 95% CI: 1.66–1.77) or ACS alone (OR = 2.95, 95% CI: 2.85–3.05). Our study conducted in almost 1.2 million hospitalized patients provides clear evidence that patients with both CVS and ACS have a high vascular risk profile and a marked excess risk of early death.