The Prevalence Of Coronary Risk Factors Among Patients Undergoing Their First Percutaneous Coronary Intervention: Insights From The Blue Cross Blue Shield Of Michigan Cardiovascular Consortium

Background: Coronary artery disease (CAD) is the leading cause of death globally and risk factors for CAD are well established. Although there has been a decline in the incidence of CAD in recent years, understanding the risk factor profile of patients presenting with cardiac disease in contemporary practice may help define current unmet challenges in preventing CAD. Objectives: To evaluate the prevalence of CAD risk factors among patients undergoing percutaneous coronary intervention (PCI) and assess how they have changed over time. Methods: We assessed the prevalence of risk factors among patients without a history of prior myocardial infarction, PCI, or coronary artery bypass graft surgery who underwent PCI at 47 non-federal hospitals in the state of Michigan between 1/1/2010 and 3/31/2018 using the BMC2 PCI registry. Results: Our study cohort included 69,970 men and 39,106 women. Traditional risk factors were highly prevalent in this population: 34.4% of men and 31.0% of women were current or recent smokers, hypertension was present in 71.8% of men and 80.6% of women, hyperlipidemia was present in 65.0% of men and 68.9% of women, diabetes was present in 27.8% of men and 35.5% of women, and 44.8% of men and 48.0% of women were obese. Over the study period, the prevalence of diabetes (29% to 32%) and obesity (45% to 48%) increased while a decline in smoking prevalence was noted (34% to 31%). Most patients had 2 or more risk factors with 51.2% having three or more risk factors. Compared with nonsmokers, smokers presented over a decade earlier (age 56.8 versus 66.9 years, p < 0.0001) and obese patients presented 4.0 years earlier (age 61.4 versus 65.4 years, p < 0.0001) (Figure). Conclusions: Modifiable risk factors are widely prevalent among patients undergoing their first PCI. Population-level interventions aimed at controlling obesity and preventing smoking could significantly delay the onset of CAD and the need for PCI.