Abstract
BackgroundCurrently, 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).MethodsMI/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.ResultsOver 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.ConclusionWe outlined the public health burden of this condition and the importance of improving the trajectories of care as an aid for better care.
Highlights
Around the world, cardiovascular disease (CVD) is recognized as the leading cause of death and is predicted to remain as such in 2030 [1]
Over the six-year period, we identified 678,021 patients, representing 900,121 stays of which, 215,224 had a myocardial infarctions (MI) and a Percutaneous Coronary Intervention (PCI)
People with MI have a risk of recurrence and/or development of coronary heart disease-related conditions six times higher than those with no history of MI [3]
Summary
Cardiovascular disease (CVD) is recognized as the leading cause of death (accounting for approximately 31% of all deaths worldwide) and is predicted to remain as such in 2030 [1] This is reinforced with by the World Health Organization (WHO), which forecasts an 11% increase in the burden of CVD by 2030, bringing the worldwide number of myocardial infarctions (MI) and stroke to approximately 36.2 million [2]. People with MI have a risk of recurrence and/or development of coronary heart disease-related conditions six times higher than those with no history of MI [3] Among these diseases, the coronary artery disease (CAD) is the most common cause, accounting for more than 40% of CVD deaths (Source WHO). CVD is 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. 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)
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