Prevalence of coronary risk factors in contemporary practice among patients undergoing their first percutaneous coronary intervention: Implications for primary prevention

• Type of Material: Article
• Authors: Zoya Gurm, Wayne State University; Milan Seth, University of Michigan Health System; Edouard Daher, Ascension St. John Hospital; Elizabeth Pielsticker, Henry Ford Allegiance Health; Imram M Qureshi, Detroit Medical Center-Sinai Grace Hospital; Mark Zainea, McLaren Macomb Hospital, Mount Clemens; Michael Tucciarone, Beaumont Hospital; George Hanzel, Emory University; Peter K Henke, University of Michigan Health System, Ann Arbor; Devraj Sukul, University of Michigan Health System, Ann Arbor
• Language: English
• Date: 2021-06-09
• Publisher: PUBLIC LIBRARY SCIENCE
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Gurm et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0250801
• Title of Journal or Parent Work: PLOS ONE
• Volume: 16
• Issue: 6
• Start Page: e0250801
• End Page: e0250801
• Grant/Funding Information: The BMC2 coordinating center is supported by a grant from Blue Cross Blue Shield of Michigan to the University of Michigan. The sponsor had no role in the study design or decision to publish this work.
• Keywords: WOMEN; STATEMENT; TRENDS; MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; Science & Technology; HEART-DISEASE; SMOKING; SEX-DIFFERENCES; US ADULTS; Science & Technology - Other Topics; OBESITY; Multidisciplinary Sciences

Abstract

Background Cigarette smoking, hypertension, dyslipidemia, diabetes, and obesity are conventional risk factors (RFs) for coronary artery disease (CAD). Population trends for these RFs have varied in recent decades. Consequently, the risk factor profile for patients presenting with a new diagnosis of CAD in contemporary practice remains unknown. Objectives To examine the prevalence of RFs and their temporal trends among patients without a history of myocardial infarction or revascularization who underwent their first percutaneous coronary intervention (PCI). Methods We examined the prevalence and temporal trends of RFs among patients without a history of prior myocardial infarction, PCI, or coronary artery bypass graft surgery who underwent PCI at 47 non-federal hospitals in Michigan between 1/1/2010 and 3/31/2018. Results Of 69,571 men and 38,930 women in the study cohort, 95.5% of patients had 1 or more RFs and nearly half (55.2% of women and 48.7% of men) had ?3 RFs. The gap in the mean age at the time of presentation between men and women narrowed as the number of RFs increased with a gap of 6 years among those with 2 RFs to <1 year among those with 5 RFs. Compared with patients without a current/recent history of smoking, those with a current/recent history of smoking presented a decade earlier (age 56.8 versus 66.9 years; p <0.0001). Compared with patients without obesity, patients with obesity presented 4.0 years earlier (age 61.4 years versus 65.4 years; p <0.0001). Conclusions Modifiable RFs are widely prevalent among patients undergoing their first PCI. Smoking and obesity are associated with an earlier age of presentation. Population-level interventions aimed at preventing obesity and smoking could significantly delay the onset of CAD and the need for PCI.