EPIDEMIOLOGY OF MYOCARDIAL-INFARCTION IN FRANCE - REGIONAL SPECIFICITIES

A national epidemiological study undertaken in November 1995 recensed the data of 2 563 patients admitted to 373 Intensive Care Units for ac ute myocardial infarction. There were 1 827 men and 736 women with an average age of 67 years. Seventeen per cent of patients had left ventr icular ejection fration (LVEF) less than or equal to 35 %. The mortali ty rate at 5 days was 7.7 %. Clinical heart failure (Killip > 1) was o bserved in 34.4 % of patients. 63 % of patients were admitted before t he 6th hour. Forty-six per cent of patients underwent early revascular isation by thrombolysis and/or angioplasty. The most widely used drugs in the first 5 days were heparin (96 %), aspirin (89 %), betablockers (65 %), and angiotension converting enzyme inhibitors (46 %). The inf luence of region on the demographical features, morbidity, mortality a nd therapeutic practice was studied. France was divided into 6 regions . In the Centre, the patients were older, with increased morbidity and mortality compared with the national average. Patients in the North E ast were similar and had a higher incidence of obesity. In the lie de France, patients were generally younger with a higher incidence of tob acco consumption and their infarcts were generally less severe. Finall y, in the South East, the mortality was particularly low. In multivari ate analysis living in this region was good prognostic factor whereas low LVEF (less than or equal to 35 %) and age greater than or equal to 65 years were poor prognostic factors. This study, for the first time in France, describes the clinical features of myocardial infarction a dmitted to the Intensive Care Unit with respect to criteria of severit y (LVEF, Killip) and region of origin of the patients. Its confirms la rge regional variations in the severity of acute myocardial infarction .