Rationale and design of the FRENch CoHort of myocardial Infarction Evaluation (FRENCHIE) study
Alexandre Gautier1, Nicolas Danchin2, Gregory Ducrocq1
1French Alliance for Cardiovascular Trials, Laboratory for Vascular Translational Science, Inserm U1148, hôpital Bichat, AP-HP, 75018 Paris, France; Université Paris Cité, 75006 Paris, France.
Insights
This study tracks over 19,000 acute myocardial infarction patients in France, analyzing their care and outcomes for up to 20 years. Findings will enhance understanding of heart attack management and prognosis in the nation.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Acute myocardial infarction (AMI) remains a leading global cause of death, necessitating contemporary data collection.
- Understanding AMI patient characteristics, management, and outcomes in France is crucial despite advances.
Purpose of the Study:
- To describe AMI patient baseline characteristics, contemporary management, and in-hospital/long-term outcomes in French tertiary centers.
- To investigate prognostic factors, including periodontal disease and sleep-disordered breathing.
- To assess care gaps and healthcare costs associated with AMI.
Main Methods:
- The FRENCHIE (FRENch CoHort of myocardial Infarction Evaluation) is a prospective, multicenter observational study.
- Enrolling over 19,000 AMI patients hospitalized since March 2019 in 35 French centers.
- Utilizing long-term follow-up via the French national health database for comprehensive outcome and cost assessment.
Main Results:
- Data collection is ongoing, with over 19,000 patients enrolled.
- Prospective data on demographics, risk factors, treatments, and initial management are being gathered.
- Long-term outcomes, including mortality and healthcare utilization, will be tracked for up to 20 years.
Conclusions:
- The FRENCHIE cohort provides valuable nationwide data on contemporary AMI management and outcomes in France.
- This large cohort with extended follow-up will inform clinical practice and public health strategies.
- It serves as a platform for nested studies and clinical trials to further investigate AMI.
Background:
Despite major advances in prevention and treatment, cardiovascular diseases - particularly acute myocardial infarction - remain a leading cause of death worldwide and in France. Collecting contemporary data about the characteristics, management and outcomes of patients with acute myocardial infarction in France is important.
Aims:
The main objectives are to describe baseline characteristics, contemporary management, in-hospital and long-term outcomes of patients with acute myocardial infarction hospitalized in tertiary care centres in France; secondary objectives are to investigate determinants of prognosis (including periodontal disease and sleep-disordered breathing), to identify gaps between evidence-based recommendations and management and to assess medical care costs for the index hospitalization and during the follow-up period.
Methods:
FRENCHIE (FRENch CoHort of myocardial Infarction Evaluation) is an ongoing prospective multicentre observational study (ClinicalTrials.gov Identifier: NCT04050956) enrolling more than 19,000 patients hospitalized for acute myocardial infarction with onset of symptoms within 48hours in 35 participating centres in France since March 2019. Main exclusion criteria are age<18 years, lack of health coverage and procedure-related myocardial infarction (types 4a and 5). Detailed information was collected prospectively, starting at admission, including demographic data, risk factors, medical history and treatments, initial management, with prehospital care pathways and medication doses, and outcomes until hospital discharge. The follow-up period (up to 20 years for each patient) is ensured by linking with the French national health database (Système national des données de santé), and includes information on death, hospital admissions, major clinical events, healthcare consumption (including drug reimbursement) and total healthcare costs. FRENCHIE is also used as a platform for cohort-nested studies - currently three randomized trials and two observational studies.
Conclusions:
This nationwide large contemporary cohort with very long-term follow-up will improve knowledge about acute myocardial infarction management and outcomes in France, and provide a useful platform for nested studies and trials.
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