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.
Keywords
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Article info
Publication history
Published online: February 16, 2023
Accepted:
December 20,
2022
Received in revised form:
August 18,
2022
Received:
October 13,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
