Key result
Predicted 10-year CVD risk fell ~18% in PCI patients without prior CVD despite more risk factors.
Why the study?
There is a paucity of data on the temporal trends of cardiovascular risk factors in patients undergoing PCI without prior history of cardiovascular disease.
Observational (n=12,055)
No
Although traditional Framingham risk scores declined over time in patients undergoing PCI without prior CVD, the prevalence of individual risk factors and BMI increased, suggesting a need for updated risk assessment tools.
Answers are grounded in this paper and cite their sources.
Predicted risk decline despite rising factors cautions against legacy score reliance in PCI; leaves open need for recalibrated contemporary tools.
BACKGROUND: There is a paucity of data on the temporal trends of cardiovascular risk factors in patients undergoing percutaneous coronary intervention (PCI). We investigated the secular trends of risk profiles of patients undergoing PCI without prior history of cardiovascular disease (CVD). HYPOTHESIS: CVD risk factors are changed over time. METHODS: This time-trend analysis from 1994 to 2010 was performed within the Mayo Clinic PCI Registry. Outcome measures were prevalence of CVD risk factors, including the Framingham risk score (FRS), at the time of admission for PCI. RESULTS: During this period, 12,055 patients without a history of CVD (mean age, 65.0 ± 12.4 years, 67% male) underwent PCI at the Mayo Clinic. Age distribution slightly shifted toward older age (P for trend <0.05), but sex did not change over time. Despite a higher prevalence of hypertension, hypercholesterolemia, and diabetes mellitus over time, actual blood pressure and lipid profiles improved (P for trend <0.001). Over time, FRS and 10-year CVD risk improved significantly (7.3 ± 3.2 to 6.5 ± 3.3, P for trend <0.001; and 11.0 to 9.0, P for trend <0.001, respectively). Body mass index, not included in the FRS, increased significantly (29.0 ± 5.2 to 30.1 ± 6.2 kg/m(2) , P for trend <0.001), whereas smoking prevalence did not change. CONCLUSIONS: The current study demonstrates that although traditional FRS and its associated predicted 10-year cardiovascular risk declined over time, the prevalence of risk factors increased in patients undergoing PCI. The study suggests the need for a new risk-factor assessment in this patient population.
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Lee et al. (2014) conducted an observational in Patients undergoing PCI without prior history of cardiovascular disease (n=12,055). Time period (1994 to 2010) vs. Earlier time periods was evaluated on Prevalence of CVD risk factors, including the Framingham risk score (FRS), at the time of admission for PCI (p=<0.001). Over a 17-year period, the predicted 10-year cardiovascular risk declined from 11.0 to 9.0 (P<0.001) in patients undergoing PCI without prior CVD, despite an increased prevalence of risk factors.
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