Estimating the Future Burden of Myocardial Infarction in France Until 2035: An Illness-Death Model-Based Approach

Johann Kuhn,1 Valérie Olié,2 Clémence Grave,2 Yann Le Strat,1 Christophe Bonaldi,1 Pierre Joly3 1Department of Support, Data Processing and Analysis, French National Public Health Agency, Saint-Maurice, France; 2Department of Chronic Diseases and Injuries, French National Public Health Agency, Saint-Maurice, France; 3Centre Inserm U1219 – Bordeaux Population Health, Université de Bordeaux - ISPED, Bordeaux, FranceCorrespondence: Johann Kuhn, Department of Support, Data Processing and Analysis, French National Public Health Agency, 12 rue du Val d’Osne, Saint-Maurice, 94410, France, Tel/Fax +33 1 71 80 15 44, Email johann.kuhn@santepubliquefrance.frPurpose: In France, myocardial infarction (MI) was the second leading cause of years of life lost in 2019. Estimating the burden of MI in future years could help policymakers and other actors anticipate care and prevention needs and guide them in public health decision-making.Materials and Methods: Using data from the French hospital discharge database from 2007 to 2015 (n = 519,400), demographic data, and an illness-death model, we projected incidence, prevalence, number of prevalent cases and mean age of incident MI cases in France. The methodology took into account the age-cohort effect on MI incidence, mortality of healthy and diseased subjects, and the time since disease onset.Results: Projections highlighted an increase in MI prevalence in men between 2015 and 2035 from 2.52% (95% uncertainty interval (UI): [2.48– 2.56]) in 2015 to 4.02% ([3.92– 4.12]) in 2035, and from 0.85% ([0.83– 0.87]) to 1.44% ([1.38– 1.50]) in women. This corresponds to an increase of 365,000 cases between 2015 and 2035 (+81.1%) for men and 146,000 cases for women (+88.0%). The difference in the mean age of incident cases between men and women decreased from 9.52 in 2015 to 5.49 years in 2035.Conclusion: Our projections forecast an increase in MI prevalence between 2015 and 2035 in men and women, especially in relatively younger women. Using statistical models such as ours can help assess the impact of prevention campaigns for the main cardiovascular disease risk factors on the future MI prevalence.Keywords: myocardial infarction, projection, burden, prevalence, incidence, age-period-cohort model