L'Affaire du Coeur in the United States and France: The Prevalence and Treatment of Ischemic Heart Disease in Two Nations and their World Cities

We examine, for residents in two nations (U.S. and France) and the hearts of two world cities (New York, and Paris), differences in rates of mortality and hospital discharge, by area of residence, for ischemic heart disease (IHD), acute myocardial infarction (AMI), and rates of revascularization. To assess the relationship between treatment rates and the prevalence of IHD, we introduce an index based on the ratio of procedure rates to AMI hospital discharge rates and mortality. After accounting for disease prevalence, we find that procedure rates are lower in Manhattan than in Paris for both age groups, and lower in the United States than France among the 45-64 year old cohort.