Epidemiology, treatment patterns and outcomes in patients with coronary or lower extremity artery disease in France

Background. - There is a dearth of updated epidemiological data on the prevalence and annual incidence of coronary artery disease (CAD) and lower extremity artery disease (LEAD) in Western countries. Aims. - To describe the incidence and prevalence of CAD and LEAD, associated medication patterns and long-term outcomes in France. Methods. - This was a retrospective cohort study using French claims data from a representative sample of the French general population. Any hospitalization or long-term disease status for CAD or LEAD between January 2010 and December 2016 was collected to identify incident cases. Results. - Of the 763,338 patients screened in the study period, 8559 incident cases of CAD and 4399 of LEAD were identified, with an overall mean follow-up of 2.9 +/- 2.0 years. The incidence of CAD, LEAD and CAD or LEAD remained stable over the years, and in 2016 were at 33.5 per 10,000 person-years, 15.1 per 10,000 person-years and 42.5 per 10,000 person-years, respectively. The prevalence of CAD increased from 3.1% in 2010 to 4.2% in 2016, and LEAD from 1.6% to 2.4%. Most patients received guideline-recommended medication with antithrombotic drugs and lipid-lowering drugs following the index event. However, most of the medications initiated were subsequently discontinued during follow-up. Incident CAD or LEAD was associated with considerable morbidity-particularly an incidence of all-cause hospitalization of 7976.9 per 10,000 person-years-and all-cause mortality, with an incidence of 542.8 per 10,000 person-years. Conclusion. - In recent years, the prevalence of CAD or LEAD has increased progressively, resulting in considerable morbidity and mortality. (C) 2019 Elsevier Masson SAS. All rights reserved.