Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France

Background This study aimed to assess attack rates of ischemic cerebrovascular events (CVEs) in a population‐based registry and to estimate the current and projected burden of the disease in whole France. Methods and Results All cases of ischemic CVE (including ischemic stroke and transient ischemic...

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Main Authors: Yannick Béjot, Gauthier Duloquin
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.037925
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author Yannick Béjot
Gauthier Duloquin
author_facet Yannick Béjot
Gauthier Duloquin
author_sort Yannick Béjot
collection DOAJ
description Background This study aimed to assess attack rates of ischemic cerebrovascular events (CVEs) in a population‐based registry and to estimate the current and projected burden of the disease in whole France. Methods and Results All cases of ischemic CVE (including ischemic stroke and transient ischemic attack) were prospectively identified through the population‐based Dijon Stroke Registry, France (2013–2020). Annual attack rates and temporal trends were assessed. The number of patients in whole France and projections by 2050 were estimated by standardization to age‐ and sex‐specific attack rates. A total of 2869 cases of ischemic CVE were recorded (mean age, 75.7±15.9 years, 54.4% women) including 1763 ischemic stroke and 1106 transient ischemic attack (crude attack rate, 230/100 000 per year). The age‐standardized rate was 237 (95% CI, 229–246), with rates of 144 (95% CI, 137–150) for ischemic stroke and 93 (95% CI, 88–98) for transient ischemic attack. The rates were 152 (95% CI, 145–159) and 85 (95% CI, 80–90), respectively, when considering the tissue‐based American Heart Association/American Stroke Association definition. The attack rate during the 2019 to 2020 period was slightly lower than that observed during 2013 to 2014 (age‐standardized attack rate ratio, 0.90[95% CI, 0.81–0.99]; P=0.035) but did not differ from that of other periods. The number of ischemic CVEs was estimated to be 164 126 annually in France during 2013 to 2020. An increase of 35% and 56% is expected by 2035 and 2050, respectively. Conclusions Our study highlighted a high burden of ischemic CVE that has been largely underestimated in France by administrative databases. Despite roughly stable attack rates over time, the absolute number of cases is expected to dramatically increase in coming years, thus questioning the sustainability of the health care system.
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spelling doaj-art-bd00c628370c4cec82e447b8c43ee3d22025-08-20T03:24:32ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-01-0114210.1161/JAHA.124.037925Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, FranceYannick Béjot0Gauthier Duloquin1Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardiocerebrovascular Diseases (PEC2) University of Burgundy FranceDijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardiocerebrovascular Diseases (PEC2) University of Burgundy FranceBackground This study aimed to assess attack rates of ischemic cerebrovascular events (CVEs) in a population‐based registry and to estimate the current and projected burden of the disease in whole France. Methods and Results All cases of ischemic CVE (including ischemic stroke and transient ischemic attack) were prospectively identified through the population‐based Dijon Stroke Registry, France (2013–2020). Annual attack rates and temporal trends were assessed. The number of patients in whole France and projections by 2050 were estimated by standardization to age‐ and sex‐specific attack rates. A total of 2869 cases of ischemic CVE were recorded (mean age, 75.7±15.9 years, 54.4% women) including 1763 ischemic stroke and 1106 transient ischemic attack (crude attack rate, 230/100 000 per year). The age‐standardized rate was 237 (95% CI, 229–246), with rates of 144 (95% CI, 137–150) for ischemic stroke and 93 (95% CI, 88–98) for transient ischemic attack. The rates were 152 (95% CI, 145–159) and 85 (95% CI, 80–90), respectively, when considering the tissue‐based American Heart Association/American Stroke Association definition. The attack rate during the 2019 to 2020 period was slightly lower than that observed during 2013 to 2014 (age‐standardized attack rate ratio, 0.90[95% CI, 0.81–0.99]; P=0.035) but did not differ from that of other periods. The number of ischemic CVEs was estimated to be 164 126 annually in France during 2013 to 2020. An increase of 35% and 56% is expected by 2035 and 2050, respectively. Conclusions Our study highlighted a high burden of ischemic CVE that has been largely underestimated in France by administrative databases. Despite roughly stable attack rates over time, the absolute number of cases is expected to dramatically increase in coming years, thus questioning the sustainability of the health care system.https://www.ahajournals.org/doi/10.1161/JAHA.124.037925incidenceischemic strokepopulation‐based studyregistertransient ischemic attack
spellingShingle Yannick Béjot
Gauthier Duloquin
Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
incidence
ischemic stroke
population‐based study
register
transient ischemic attack
title Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
title_full Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
title_fullStr Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
title_full_unstemmed Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
title_short Current and Projected Burden of Ischemic Cerebrovascular Events: Nationwide Estimates From the Dijon Stroke Registry, France
title_sort current and projected burden of ischemic cerebrovascular events nationwide estimates from the dijon stroke registry france
topic incidence
ischemic stroke
population‐based study
register
transient ischemic attack
url https://www.ahajournals.org/doi/10.1161/JAHA.124.037925
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