Epidemiology of hospitalized heart failure in France based on national data over 10 years, 2012-2022

Aims: We aim to describe the incidence of HF hospitalization in France in the post-pandemic era, the prevalence of HF cases and patients' characteristics, management and outcomes while focusing on sex, age and socio-economic differences and to analyse time-trends between 2012 and 2022.

Methods and results: Based on the French health care database providing medical information for almost the whole French population, patients hospitalized for acute decompensated HF without history of HF in the 5 years were identified by the International Classification of Diseases - 10th revision (ICD-10) codes. In 2022, the estimated prevalence of HF was 1.7% in France and has increased until the COVID-19 pandemic and decreased thereafter. The incidence of acute HF decompensation reached 201.4 per 100 000 inhabitants and has decreased since 2012 (-1% per year). A significant increase of the HF incidence was found in men aged <45 years. Women aged <65 years were less likely to be admitted in a cardiac rehabilitation (CR) unit and had higher probability of one-year mortality compared with men of the same age. One-year mortality was significantly increased in patients from the most deprived area among extreme age group only (under 65 and ≥85 years). One-year rehospitalization rates have decreased significantly, particularly in men aged <75 years. A decrease in ACE/ARBs deliveries was observed in both men and women.

Conclusions: Despite the decrease in acute HF decompensation incidence and improvements in the management, the prevalence of HF remains stable in France and prognosis remains poor.