Baseline cardiovascular risk and primary prevention in STEMI patients: insights from a tertiary center

Abstract Introduction and objectives Cardiovascular disease (CVD) risk assessment allows the identification of individuals at risk that could benefit from pharmacological intervention in primary prevention. The aim of this study is to evaluate baseline CVD risk of patients admitted with ST-elevation myocardial infarction (STEMI), assess STEP 1 and STEP 2 accomplishment and determine predictors of appropriate CVD control. Methods A retrospective, observational study was conducted on 202 patients diagnosed with STEMI between January 1st, 2022 and March 31, 2023. Risk stratification was performed using the ESC 2021 Guidelines on cardiovascular disease prevention in clinical practice, and compliance with STEP 1 and STEP 2 (target LDL-C and systolic blood pressure control) was analysed. Lifestyle changes were not addressed in this study. Results Patients presented a mean age of 61.8 years (±11.4). CV risk stratification identified 56.4% (n= 114) patients with high and 40.1% (n= 81) with very high risk. Concerning CV risk control, at the time of the event, only 10.9% of patients (n=22) met STEP 1 criteria, and just 2 patients achieved STEP 2. Age was significantly associated with the accomplishment of STEP 1 (OR: 1.069; p= 0.001). Statin use and recent analytical study at the general practitioner showed no significant association with STEP 1 compliance. Conclusion Most patients who develop STEMI failed to meet ESC 2021 Guidelines on cardiovascular disease prevention, despite their high baseline CVD risk. Age emerged as a predictor of compliance with CV prevention strategies, emphasizing the need for targeted interventions among the younger population.