Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Jan 2025)

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

  • Yannick Béjot,
  • Gauthier Duloquin

DOI
https://doi.org/10.1161/JAHA.124.037925
Journal volume & issue
Vol. 14, no. 2

Abstract

Read online

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.

Keywords