TY - JOUR
T1 - Trends in modifiable risk factors amongst first presentation ST elevation myocardial infarction patients in a large longitudinal registry
AU - Kazi, Samia N.
AU - Huben, Amy Von
AU - Marschner, Simone
AU - Chong, James J. H.
AU - Denniss, Alan Robert
AU - Ong, Andrew T. L.
AU - Chow, Clara K.
N1 - Publisher Copyright:
© 2023
PY - 2023/4
Y1 - 2023/4
N2 - Background: Recent studies suggest that the risk factor profile of patients presenting with ST elevation myocardial infarction (STEMI) is changing. Aim: The aim is to determine if there has been a shift of cardiovascular risk factors to cardiometabolic causes in the first presentation STEMI population. Method: We analysed data from a STEMI registry from a large tertiary referral percutaneous coronary intervention centre to determine the prevalence and trends of the modifiable risk factors of hypertension, diabetes, smoking and hypercholesterolaemia. Participants: Consecutive first presentation STEMI patients between January 2006 to December 2018. Results: Among the 2,366 patients included (mean age 59, SD 12.66, 80% male) the common risk factors were hypertension (47%), hypercholesterolaemia (47%) current smoking (42%) and diabetes (27%). Over the 13 years, patients with diabetes (20% to 26%, OR 1.09 per year, CI 1.06–1.11, p<0.001) and patients with no modifiable risk factors increased (9% to 17%, OR 1.08, CI 1.04–1.11, p<0.001). Concurrently there was a fall in prevalence of hypercholesterolaemia, (47% to 37%, OR 0.94 per year, CI 0.92–0.96, p<0.001) and smoking (44% to 41%, OR 0.94, CI 0.92–0.96, p<0.001) but no significant change in rates of hypertension (53% to 49%, OR 0.99, CI 0.97–1.01, p=0.25). Conclusion: The risk factor profile of first presentation STEMI has changed over time with a reduction in smoking and a concurrent rise in patients with no traditional risk factors. This suggests the mechanism of STEMI may be changing and further investigation of potential causal factors is warranted for the prevention and management of cardiovascular disease.
AB - Background: Recent studies suggest that the risk factor profile of patients presenting with ST elevation myocardial infarction (STEMI) is changing. Aim: The aim is to determine if there has been a shift of cardiovascular risk factors to cardiometabolic causes in the first presentation STEMI population. Method: We analysed data from a STEMI registry from a large tertiary referral percutaneous coronary intervention centre to determine the prevalence and trends of the modifiable risk factors of hypertension, diabetes, smoking and hypercholesterolaemia. Participants: Consecutive first presentation STEMI patients between January 2006 to December 2018. Results: Among the 2,366 patients included (mean age 59, SD 12.66, 80% male) the common risk factors were hypertension (47%), hypercholesterolaemia (47%) current smoking (42%) and diabetes (27%). Over the 13 years, patients with diabetes (20% to 26%, OR 1.09 per year, CI 1.06–1.11, p<0.001) and patients with no modifiable risk factors increased (9% to 17%, OR 1.08, CI 1.04–1.11, p<0.001). Concurrently there was a fall in prevalence of hypercholesterolaemia, (47% to 37%, OR 0.94 per year, CI 0.92–0.96, p<0.001) and smoking (44% to 41%, OR 0.94, CI 0.92–0.96, p<0.001) but no significant change in rates of hypertension (53% to 49%, OR 0.99, CI 0.97–1.01, p=0.25). Conclusion: The risk factor profile of first presentation STEMI has changed over time with a reduction in smoking and a concurrent rise in patients with no traditional risk factors. This suggests the mechanism of STEMI may be changing and further investigation of potential causal factors is warranted for the prevention and management of cardiovascular disease.
KW - Myocardial infarction
KW - Heart disease risk factors
KW - Cardiometabolic risk factors
KW - ST elevation myocardial infarction
KW - Cardiovascular diseases
UR - https://hdl.handle.net/1959.7/uws:72737
UR - http://www.scopus.com/inward/record.url?scp=85148743229&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2022.12.012
DO - 10.1016/j.hlc.2022.12.012
M3 - Article
SN - 1444-2892
SN - 1443-9506
VL - 32
SP - 480
EP - 486
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 4
ER -