Nationwide time trends in patients hospitalized for acute coronary syndrome : a worrying generational and social effect among women
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
AIMS: To estimate the time trends in the annual incidence of patients hospitalized for acute coronary syndrome (ACS) in France from 2009 to 2021 and to analyse the current sex and social differences in ACS, management, and prognosis.
METHODS AND RESULTS: All patients hospitalized for ACS in France were selected from the comprehensive National Health Insurance database. Age-standardized rates were computed overall and according to age group (over or under 65 years), sex, proxy of socioeconomic status, and ACS subtype [ST-segment elevation (STSE) and non-ST-segment elevation]. Patient characteristics and outcomes were described for patients hospitalized in 2019. Differences in management (coronarography, revascularization), and prognosis were analysed by sex, adjusting for cofonders. In 2019, 143,670 patients were hospitalized for ACS, including 53,227 STSE-ACS (mean age = 68.8 years; 32% women). Higher standardized incidence rates among the most socially deprived people were observed. Women were less likely to receive coronarography and revascularization but had a higher excess in-hospital mortality. In 2019, the age-standardized rate for hospitalized ACS patients reached 210 per 100 000 person-year. Between 2009 and 2019, these rates decreased by 11.4% (men: -11.2%; women: -14.0%). Differences in trends of age-standardized incidence rate have been observed according to sex, age, and social status. Middle aged women (45-64 years) showing more unfavourable trends than in other age classes or in men. In addition, among women the temporal trends were more unfavourable as social deprivation increased.
CONCLUSION: Despite encouraging overall trends in patients hospitalized for ACS rates, the increasing trends observed among middle-aged women, especially socially deprived women, is worrying. Targeted cardiovascular prevention and close surveillance of this population should be encouraged.
| Errataetall: |
ErratumIn: Eur J Prev Cardiol. 2024 Mar 27;:. - PMID 38537614 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
European journal of preventive cardiology - 31(2024), 1 vom: 05. Jan., Seite 116-127 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Grave, Clémence [VerfasserIn] |
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| Links: |
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| Themen: |
Acute coronary syndrome |
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| Anmerkungen: |
Date Completed 08.01.2024 Date Revised 27.03.2024 published: Print ErratumIn: Eur J Prev Cardiol. 2024 Mar 27;:. - PMID 38537614 Citation Status MEDLINE |
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| doi: |
10.1093/eurjpc/zwad288 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM362884722 |
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| 500 | |a ErratumIn: Eur J Prev Cardiol. 2024 Mar 27;:. - PMID 38537614 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a AIMS: To estimate the time trends in the annual incidence of patients hospitalized for acute coronary syndrome (ACS) in France from 2009 to 2021 and to analyse the current sex and social differences in ACS, management, and prognosis | ||
| 520 | |a METHODS AND RESULTS: All patients hospitalized for ACS in France were selected from the comprehensive National Health Insurance database. Age-standardized rates were computed overall and according to age group (over or under 65 years), sex, proxy of socioeconomic status, and ACS subtype [ST-segment elevation (STSE) and non-ST-segment elevation]. Patient characteristics and outcomes were described for patients hospitalized in 2019. Differences in management (coronarography, revascularization), and prognosis were analysed by sex, adjusting for cofonders. In 2019, 143,670 patients were hospitalized for ACS, including 53,227 STSE-ACS (mean age = 68.8 years; 32% women). Higher standardized incidence rates among the most socially deprived people were observed. Women were less likely to receive coronarography and revascularization but had a higher excess in-hospital mortality. In 2019, the age-standardized rate for hospitalized ACS patients reached 210 per 100 000 person-year. Between 2009 and 2019, these rates decreased by 11.4% (men: -11.2%; women: -14.0%). Differences in trends of age-standardized incidence rate have been observed according to sex, age, and social status. Middle aged women (45-64 years) showing more unfavourable trends than in other age classes or in men. In addition, among women the temporal trends were more unfavourable as social deprivation increased | ||
| 520 | |a CONCLUSION: Despite encouraging overall trends in patients hospitalized for ACS rates, the increasing trends observed among middle-aged women, especially socially deprived women, is worrying. Targeted cardiovascular prevention and close surveillance of this population should be encouraged | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute coronary syndrome | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a France | |
| 650 | 4 | |a Nationwide | |
| 650 | 4 | |a Sex disparities | |
| 650 | 4 | |a Social disparities | |
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| 700 | 1 | |a Cinaud, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Tuppin, Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a Blacher, Jacques |e verfasserin |4 aut | |
| 700 | 1 | |a Olié, Valérie |e verfasserin |4 aut | |
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