First myocardial infarction: risk factors, symptoms, and medical therapy

作者：Nick S. Nurmohamed, Quyen Ngo‐Metzger, Pam R. Taub, Kausik K Ray, Gemma A. Figtree, Marc P. Bonaca, Judith Hsia, Santosh Angadageri, James P. Earls, Fatima Rodriguez, Alexander T. Sandhu, James K. Min, Udo Hoffmann, David J. Maron, Deepak L. Bhatt · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf390 · 被引用次数：40 · 研究领域：Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics、Cardiac Health and Mental Health

BACKGROUND AND AIMS: Despite the implementation of clinical risk algorithms based on traditional risk factors, the global burden of atherosclerotic cardiovascular disease has continued to rise over the past decades. There are few real-world data on prevalence of both symptoms and risk factors prior to myocardial infarction (MI). This study aimed to investigate the prevalence of documented coronary artery disease risk factors, documented symptoms, physician visits, and preventive therapy uptake prior to first MI. METHODS: In this retrospective cohort study, US patients ≥18 years with a first MI [International Classification of Diseases, 10th Revision (ICD-10) definition] between 1 January 2017 and 30 September 2022 were included from the Clarivate Real-World Data Product that links electronic health records, medical claims, and pharmacy claims from 98% of government and commercial health insurance plans in the US. Prevalence of previously ICD-10 documented cardiac symptoms and standard modifiable risk factors (SMuRFs), physician visits, and use of preventive medical therapy were assessed prior to MI. RESULTS: The study identified 4 657 412 patients with a first MI (2017-2022), with a median age of 70 years; 42.3% were women. Prior to MI, 50.5% of patients had no documented symptoms, 18.0% had no SMuRFs, 22.2% did not have documented physician visits, and 63.4% were not prescribed any preventive therapy. Individuals ≤60 years and men were less likely to have documented symptoms...