EPIDEMIOLOGY, REGIONAL DISPARITIES AND DETERMINANTS OF HOSPITALIZATION OF OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY IN FRANCE: A NATIONAL CLAIMS ANALYSIS
Author(s)
Patricia Reant, MD, PhD1, Jeanne Lacroix, MPH2, Caroline Guilmet, PharmD2, Roxane Galibert, PharmD2, Quitterie Poussineau, PharmD3, Jules Chassetuillier, MSc3, Cécile Conte Gineste, PharmD, PhD3, Aurélie Schmidt, MSc3, Olivier Huttin, MD, PhD4.
1Centre de référence des cardiomyopathies héréditaires ou rares, Bordeaux University Hospital (CHU), Univ. Bordeaux, INSERM U1045, Bordeaux, France, 2Bristol Myers Squibb, Rueil-Malmaison, France, 3HEVA, Lyon, France, 4Service de cardiologie, Institut lorrain du cœur et des vaisseaux, CHRU de Nancy, Vandœuvre-lès-Nancy, France.
1Centre de référence des cardiomyopathies héréditaires ou rares, Bordeaux University Hospital (CHU), Univ. Bordeaux, INSERM U1045, Bordeaux, France, 2Bristol Myers Squibb, Rueil-Malmaison, France, 3HEVA, Lyon, France, 4Service de cardiologie, Institut lorrain du cœur et des vaisseaux, CHRU de Nancy, Vandœuvre-lès-Nancy, France.
OBJECTIVES: To estimate hospital incidence and prevalence of obstructive hypertrophic cardiomyopathy (oHCM) in France, describe temporal trends and cardiovascular (CV) care pathways and complications, and identify regional disparities in diagnosis and management.
METHODS: A retrospective analysis of the French national hospital discharge database (PMSI) was conducted over 2021-2024. Patients were identified based on ICD codes and/or septal reduction therapy procedures. Patients with no oHCM diagnosis in the five prior years were classified as incident cases. Incidence and prevalence rates per 100,000 inhabitants were estimated by geographic area. Multivariable regression models were used to identify medical and socio-demographic determinants of hospitalization.
RESULTS: A total of 18,562 patients were identified (8,306 incident, 10,256 non-incident). Hospital prevalence increased from 12,154 patients in 2021 to 16,893 in 2024, an average annual increase of 11.6%. Annual incidence rose from 1,898 cases in 2021 to 2,279 in 2024, representing a 20.0% increase over four years. The non-standardized 4-year incidence ranged from 8 to 82 cases per 100,000 inhabitants across geographic areas. Among incident patients, the mean age was 69 years and 52.9% were male. At inclusion, 55.0% had hypertension and 27.9% heart failure (HF), with a median Charlson comorbidity index of 4. Only 21.1% were hospitalized with oHCM as the primary cause, and 35.2% received their first diagnosis following an emergency admission. During follow-up, 23.3% experienced at least one CV hospitalization (mostly oHCM, atrial fibrillation, and HF), of which 24.3% were emergency admissions.
CONCLUSIONS: This national study demonstrates a sustained increase in hospital oHCM incidence and prevalence in France, which may reflect improved detection, a genuine rise in disease burden, or both. Disease management remains sub-optimal, with a high proportion of emergency-based first diagnoses and marked regional disparities, likely reflecting epidemiological differences and inequalities in access to diagnostic care.
METHODS: A retrospective analysis of the French national hospital discharge database (PMSI) was conducted over 2021-2024. Patients were identified based on ICD codes and/or septal reduction therapy procedures. Patients with no oHCM diagnosis in the five prior years were classified as incident cases. Incidence and prevalence rates per 100,000 inhabitants were estimated by geographic area. Multivariable regression models were used to identify medical and socio-demographic determinants of hospitalization.
RESULTS: A total of 18,562 patients were identified (8,306 incident, 10,256 non-incident). Hospital prevalence increased from 12,154 patients in 2021 to 16,893 in 2024, an average annual increase of 11.6%. Annual incidence rose from 1,898 cases in 2021 to 2,279 in 2024, representing a 20.0% increase over four years. The non-standardized 4-year incidence ranged from 8 to 82 cases per 100,000 inhabitants across geographic areas. Among incident patients, the mean age was 69 years and 52.9% were male. At inclusion, 55.0% had hypertension and 27.9% heart failure (HF), with a median Charlson comorbidity index of 4. Only 21.1% were hospitalized with oHCM as the primary cause, and 35.2% received their first diagnosis following an emergency admission. During follow-up, 23.3% experienced at least one CV hospitalization (mostly oHCM, atrial fibrillation, and HF), of which 24.3% were emergency admissions.
CONCLUSIONS: This national study demonstrates a sustained increase in hospital oHCM incidence and prevalence in France, which may reflect improved detection, a genuine rise in disease burden, or both. Disease management remains sub-optimal, with a high proportion of emergency-based first diagnoses and marked regional disparities, likely reflecting epidemiological differences and inequalities in access to diagnostic care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH55
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas