Time-trend analysis on the Framingham risk score and prevalence of cardiovascular risk factors in patients undergoing percutaneous coronary intervention without prior history of coronary vascular disease over the last 17 years: a study from the Mayo Clinic PCI registry.

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.