Having ≤1 controlled standard modifiable risk factor before PCI was associated with a higher risk of one-year MACE compared to having 4 controlled factors (adjHR 1.48; 95% CI 1.10-2.00).
Cohort (n=19,651)
No
Does the number of controlled standard modifiable risk factors impact the risk of MACE at one year in patients undergoing PCI?
Comprehensive control of standard modifiable risk factors before PCI is associated with lower MACE rates at one year, with glycemic control showing the most significant benefit.
Hazard Ratio: 1.48 (95% CI 1.1–2)
BACKGROUND AND AIMS: Standard modifiable risk factors (SMuRFs), including hypertension, diabetes, hyperlipidaemia, and smoking, are prevalent among patients undergoing percutaneous coronary intervention (PCI). This study aimed to assess the prevalence and impact of controlled SMuRFs in patients undergoing PCI. METHODS: Data of patients who underwent PCI at a single tertiary-care centre between 2012 and 2023 were analysed. SMuRF control was assessed using pre-procedural measurements: systolic blood pressure <140 mmHg, fasting glucose <126 mg/dL or a haemoglobin A1c < 7%, low-density lipoprotein <100 mg/dL, and smoking status (non-smoker). Patients were stratified by the number of controlled risk factors (CRF): 4, 3, 2, and ≤1. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction, and stroke, at one-year post-PCI. RESULTS: Among 19 651 patients, 5876 (29.9%) had 4-CRF, 8199 (41.7%) had 3-CRF, 4415 (22.5%) had 2-CRF, and 1161 (5.9%) had ≤1-CRF. Compared with 4-CRF, the risk for MACE increased progressively with fewer controlled risk factors (3-CRF: adjHR 1.17, 95% CI 0.98-1.40; 2-CRF: adjHR 1.39, 95% CI 1.14-1.69; ≤1-CRF: adjHR 1.48, 95% CI 1.10-2.00). Glycaemic control had the most significant association with lower MACE (adjHR 0.56, 95% CI 0.49-0.65). CONCLUSIONS: Comprehensive SMuRF control before PCI remains infrequent, though it is associated with lower MACE rates. Prioritizing glycaemic control may yield the greatest benefit in improving post-PCI prognosis.
Nicolas et al. (Fri,) conducted a cohort in percutaneous coronary intervention (n=19,651). ≤1 controlled standard modifiable risk factor vs. 4 controlled standard modifiable risk factors was evaluated on major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction, and stroke, at one-year post-PCI (adjHR 1.48, 95% CI 1.10-2.00). Having ≤1 controlled standard modifiable risk factor before PCI was associated with a higher risk of one-year MACE compared to having 4 controlled factors (adjHR 1.48; 95% CI 1.10-2.00).
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