Clinical profiles and temporal trends of 37,741 cardiovascular hospitalizations in Greece over 12 years: initial insights from the CardioMining database

Abstract

Objective: Cardiovascular disease remains the leading cause of morbidity and mortality in Europe, yet nationwide data on cardiovascular hospitalizations in Greece are limited. This study aimed to examine clinical profiles and hospitalization trends of patients with cardiovascular disease in Greece from 2012 to 2023.

Methods: This retrospective cohort study utilized the CardioMining Database, which integrates electronic health record data from multiple tertiary hospitals. Temporal disease trends, treatment patterns, and subgroup differences by sex and age were assessed.

Results: A total of 37,741 hospitalizations among 33,645 patients were analyzed [median age: 70 years, 66.4% male]. The most frequent primary discharge diagnoses were coronary artery disease (CAD) (40.8%), acute decompensated heart failure (HF) (20.4%), and arrhythmias (18.6%). Hospitalizations due to chronic coronary syndrome and hypertensive heart disease gradually declined, while those due to aortic stenosis, HF, pulmonary embolism, pericarditis, and non-ST-elevation acute coronary syndrome increased. The overall prevalence of HF with reduced ejection fraction, valvular heart disease (VHD), pulmonary embolism, and tachyarrhythmias rose over time. Sodium-glucose cotransporter-2 inhibitors, mineralocorticoid receptor antagonists, non-vitamin K antagonist oral anticoagulants, and statin-ezetimibe therapy showed increased use, while vitamin K antagonists and dual antiplatelet therapy declined. Percutaneous coronary interventions declined over time. Women had higher rates of VHD, arrhythmias, and pulmonary embolism; men had more CAD and cardiomyopathies. Older patients more frequently had HF and VHD, while younger patients had more ischemic events and myo/endocarditis.

Conclusion: This first nationwide analysis of cardiovascular hospitalizations in Greece highlights evolving trends that support the need for data-driven policies and personalized care.

Keywords: Cardiovascular hospitalizations; Electronic health records; Epidemiology; Temporal trends.