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

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

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Databases, Factual / trends*
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Hospitalization / trends*
  • Humans
  • Insurance Claim Review / trends*
  • Male
  • Middle Aged
  • Mortality / trends
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality*
  • Myocardial Infarction / therapy
  • Secondary Prevention / methods
  • Secondary Prevention / trends
  • Treatment Outcome
  • Young Adult