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. 2023 Feb 1;44(5):383-392.
doi: 10.1093/eurheartj/ehac651.

Epidemiology of heart failure in young adults: a French nationwide cohort study

Emmanuel Lecoeur  1 , Orianne Domeng  2   3 , Antoine Fayol  2   3 , Anne-Sophie Jannot  1 , Jean-Sbastien Hulot  2   3
Affiliations

Epidemiology of heart failure in young adults: a French nationwide cohort study

Emmanuel Lecoeur et al. Eur Heart J. .

Erratum in

Abstract

Aims: Heart failure (HF) in young adults is uncommon, and changes in its incidence and prognosis in recent years are poorly described.

Methods and results: The incidence and prognosis of HF in young adults (1850 years) were characterized using nationwide medico-administrative data from the French National Hospitalization Database (period 20132018). A total of 1,486 877 patients hospitalized for incident HF were identified, including 70 075 (4.7) patients aged 1850 years (estimated incidence of 0.44 for this age group). During the study period, the overall incidence of HF tended to decrease in the overall population but significantly increased by 0.041 in young adults (P 0.001). This increase was notably observed among young men (from 0.51 to 0.59, P 0.001), particularly those aged 3650 years. In these young men, ischaemic heart disease (IHD) was the most frequently reported cause of HF, whereas non-ischaemic HF was mainly observed in patients 35 years old. In contrast to non-ischaemic HF, the incidence of IHD increased over the study period, which suggests that IHD-related HF is progressively affecting younger patients. Concordantly, young HF patients presented with high rates of traditional IHD risk factors, including obesity, smoking, hypertension, dyslipidaemia, or diabetes. Lastly, the rates of re-hospitalization (for HF or for any cause) within two years after the first HF event and in-hospital mortality were high in all groups, indicating a poor-prognosis population.

Conclusion: Strategies for the prevention of HF risk factors should be strongly considered for patients under 50 years old.

Keywords: Epidemiology; Heart failure; Ischaemia; Risk factors; Young people.

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Conflict of interest statement

Conflict of interest: The APHP, which employs Pr. J.-S.H., has received research grants from Bioserenity, Pliant Thx, Sanofi, Servier, and Novo Nordisk. He has also received speaker, advisory board, or consultancy fees from Alnylam, Amgen, Astra Zeneca, Bayer, Bioserenity, Boerhinger Ingelheim, MSD, Novartis, Novo Nordisk, and Vifor Pharma, all unrelated to the present work. Other authors declare no competing financial interests.

Figures

Structured Graphical Abstract
Structured Graphical Abstract
A French nationwide cohort study of HF in young adults (18–50 years): study design and summary results. Analysis results on 1 486 877 patients (all age groups) hospitalized with incident HF and identified on medico-administrative data from the French National Hospitalization Database (period 2013–18) identified 70 075 patients aged 18–50 years and showed increasing incidence of heart failure and ischaemic heart disease in young men.
Figure 1
Figure 1
(A) Incidence of heart failure in the French population (all age groups) from 2013 to 2018. (B) Standardized incidence of heart failure in the 18–50-year-old French population. (C) Incidence of heart failure according to age from 2013 to 2018 in the young French population (18–50 years) assessed in this study. (D) Incidence of heart failure according to age from 2013 to 2018 in men and women. (E) Relative evolution of incidence of heart failure between 2013 and 2018 in the young population according to age group and gender.
Figure 2
Figure 2
(A) Concomitant diagnosis [myocarditis–cardiomyopathy (red), ischaemic heart disease (green), or other-not stated (grey)] either within the 2 years prior to or at the time of hospitalization for heart failure for men and women according to age group. (B) Relative evolution of incidence of myocarditis–cardiomyopathy (red), IHD (green), or other-not stated (grey) over the 2013–18 study period in the young male population aged 41–50 years. (C/D) Kaplan–Meier estimations of having a prior ischaemic heart disease preceding the first heart failure hospitalization according to age group in men (C) and women (D). (E/F) Kaplan–Meier estimations of having a prior myocarditis/cardiomyopathy preceding the first heart failure hospitalization according to age group in men (E) and women (F). P < 0.001 for all comparisons.
Figure 3
Figure 3
According to age group, gender, and the primary aetiology (categories myocarditis–cardiomyopathy, ischaemic heart disease, and other-not stated): (A) Observed proportion of re-hospitalization for heart failure within 2 years after the first heart failure event. (B) Observed proportion of any re-hospitalization within 2 years after the first heart failure event. (C) Observed proportion of death within 2 years after the first heart failure event.
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Comment in

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