Trends in Use of Coronary Angiography, Percutaneous Coronary Intervention, and Coronary Artery Bypass Graft Over a Decade in France: A Nationwide Cohort Study

Background Coronary angiography, percutaneous coronary intervention (PCI), and coronary artery bypass graft are among the most commonly performed procedures globally. The influence of recent scientific evidence on national‐level temporal trends remains poorly explored. Methods The frequency, characteristics, and outcomes of elective and nonelective coronary angiography, PCI, and coronary artery bypass graft were described using the French National Hospitalization Database from 2014 to 2023 (covering a population of 67.0 million inhabitants), totaling 6 290 951 coronary interventions among 2 985 822 patients (mean age, 67.8±12.2 years; 69.9% men). Results Over 10 years, the annual number of coronary interventions increased by 33%, driven by a rise in coronary angiography (+32%) and PCI (+40%), while coronary artery bypass graft decreased (−8%). The growth in PCI was predominantly related to an increase in elective procedures (from 53.5% to 56.9%, P <0.001), particularly among older patients (+73%), and in multivessel disease (from 16.7% in 2014–2015 to 19.0% in 2022–2023, P <0.001). Attempts to recanalize chronic total coronary occlusion doubled (from 1.9% to 3.3%, P <0.001). In‐hospital death after PCI decreased (from 2.05% in 2014 to 1.58% in 2023, P for trend<0.001), with the most notable improvements observed in nonelective PCI. Similarly, in‐hospital death after coronary artery bypass graft declined (from 3.5% to 2.9%, P <0.001). Conclusions These findings underscore a significant increase in both coronary angiography and PCI over the past decade in France, particularly in procedures classified as elective among older patients. This trend raises questions about the influence of recent scientific evidence and guidelines on clinical practice in this country.