Acute coronary syndrome in women: rising hospitalizations in middle-aged French women, 2004-14.
We aimed to analyse trends in annual incidence of hospitalized acute coronary syndrome (ACS) in France from 2004 to 2014.



Primary diagnosis of ACS and subtypes on admissions were selected in national and exhaustive French Hospitalization Database from 2004 to 2014. Age-standardized rates were computed using standardization on the census of the 2010 European population and mean annual percent changes were estimated by using Poisson regression model. In 2014, 113 407 patients, 36 480 women (32.2%) and 76 927 men (67.8%) were hospitalized for ACS. Among women, the proportion aged under 65 years was 25.2% (n = 9206) and there was 34.4% of STEMI, 18.2% of NSTEMI and 47.4% of UA. From 2004 to 2014, the rates of age-standardized admissions for ACS in women less than 65 years old increased by 6.3%.This rise in ACS was driven by significant increases in STEMI (+21.7%) and NSTEMI (+53.7%). The largest increase in STEMI mean annual percent change was observed among women aged 45-54 years old (+3.6%/per year). After 65 years of age, significant decreases in all ACS types were observed.



This nationwide study showed substantial rising trends in STEMI annual incidence, especially among younger women. This increase could be attributed to increase in smoking and obesity. Efforts to strengthen primary prevention of CVD in younger women is needed as the main risk factors are modifiable, and as there is a growing evidence of higher short-term mortality of CHD in women.
Department of Chronic Diseases and Injuries, The French Public Health Agency, 12 rue du Val d'Osne, 94415 Saint-Maurice cedex, France.
Amélie
A
Gabet
Department of Cardiology, European Georges-Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Paris-Descartes University, 20 Rue Leblanc, 75015 Paris, France.
Nicolas
N
Danchin
Department of Cardiology, Nancy University Hospital, 5 Rue du Morvan, 54500 Vand??e-lés-Nancy, France.
Yves
Y
Juillière
Department of Chronic Diseases and Injuries, The French Public Health Agency, 12 rue du Val d'Osne, 94415 Saint-Maurice cedex, France.
Valérie
V
Olié
D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000401:mortality; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D000072658:Non-ST Elevated Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D017678:Sex Distribution
Acute coronary syndrome; France; Hospitalizations