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Int J Cardiol. 2016 Sep 15;219:387-93. doi: 10.1016/j.ijcard.2016.06.102. Epub 2016 Jun 23.

Outcomes following acute hospitalised myocardial infarction in France: An insurance claims database analysis.

Author information

1
Bordeaux PharmacoEpi, CIC Bordeaux CIC 1401, Service de Pharmacologie Médicale, Université Bordeaux, Bordeaux, France.
2
Département de Pathologie Cardiaque, Institut Mutualiste Montsouris, Paris, France.
3
CEMKA-EVAL, Bourg-la-Reine, France. Electronic address: Stephane.bouee@cemka.fr.
4
CEMKA-EVAL, Bourg-la-Reine, France.
5
INSERM UMS 011, Villejuif, France.
6
Merck Sharpe &Dohme, Courbevoie, France.
7
Université Paris Diderot, Sorbonne-Paris Cité, and INSERM U-1148, Paris, France; FACT, an F-CRIN network, DHU FIRE, Département de Cardiologie, Hôpital Bichat, Assistance Publique - Hôpitaux de Paris, France.

Abstract

BACKGROUND:

Mortality and complications of acute myocardial infarction (AMI) in France have declined over the last twenty years, but still remain high. Practice guidelines recommend secondary prevention measures to reduce these. Insurance claims databases can be used to assess the management of post MI and other cardiovascular outcomes in everyday practice.

METHODS:

A cohort study was performed in a 1/97 representative sample of the French nationwide claims and hospitalisation database (EGB database). All adults with a documented hospitalisation for MI between 2007 and 2011 were included, and followed for three years. Data was extracted on demographics, the index admission, reimbursed medication, comorbidities, post-MI events and death.

RESULTS:

During the study period, 1977 individuals hospitalised for an MI were identified, with a mean (±SD) age of 63.8 (±14.3) years, 65.8% were men, 82.4% had hypertension and 37.6% hypercholesterolaemia. The mean duration of hospitalisation was seven days and 8.3% of patients died during hospitalisation. After discharge, the majority of patients received secondary prevention with statins (92.2%), anti-platelet drugs (95.6%), beta-blockers (86.0%) and angiotensin converting enzyme inhibitors (71.4%). After three years of follow-up post-discharge, cumulative mortality was 20.5% [18.4%;22.5%] and the cumulative incidence of reinfarction and stroke/TIA were 4.7% [95% CI: 3.7%;5.7%] and 4.1% [3.1%;5.0%], respectively.

CONCLUSIONS:

Despite high use of secondary prevention at discharge, mortality and incidence of serious cardiovascular events following MI remain high. This underscores the need to improve secondary prevention.

KEYWORDS:

Cost; Death; France; Myocardial infarction; Recurrence; Treatment

PMID:
27372604
DOI:
10.1016/j.ijcard.2016.06.102
[Indexed for MEDLINE]

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