OBJECTIVES: Estimate the incremental annual cost after a myocardial infarction (MI) METHODS: A French representative cohort of patients who had a MI in France between 2007 and 2011 was extracted from a claim database of 600,000 patients. Costs were calculated from a community perspective, restricted to direct costs and from a health insurance scheme perspective. This analysis was performed on subjects still alive one year after MI RESULTS: A total of 1,920 subjects were identified with an index MI: 2/3 were males, mean age=67.2 y, 20.6% had diabetes, 37.6% hypercholesterolemia and 82.4% hypertension. Among the 1,920 subjects, 346 died in the first year and 3 were lost to follow-up: the cost was performed on 1,571 patients. The annual cost from a health insurance scheme perspective approximately tripled as it increased from €3,940 to €11,914 after a MI: Hospital cost increased from €1,616 before the index MI to €6,470 after hospitalization (the cost of the index hospitalization is excluded from the cost); Average community-based care costs increased from €2,323 before the index MI to €5,443 after: Travel costs increased from 127€ to 573€; Fees related to physician consultations increased from 589€ to 1,676€ (annual mean number consultations with a general practitioner and a specialist increased from 7.6 to 10.9 and from 5.4 to 10 respectively); Fees related to laboratory tests increased from 139€ to 408€; Cost of medicinal products increased from 1,105€ to 2,283€; Cost of medical non physician health professionals increased from 380€ to 534€. It should be noted that the mean cost related to the index MI hospitalization was €5,876 . The evolution of the costs from a community perspective was similar. CONCLUSIONS: The economic impact of recurrent cardiovascular events is substantial since healthcare consumption costs almost tripled after the index MI event