Impact of the number of modifiable risk factors on clinical outcomes after percutaneous coronary intervention: An analysis from the e-Ultimaster registry

Ofer Kobo, Yaniv Levi, Rami Abu-Fanne, Clemens Von Birgelen, Antoine Guédès, Adel Aminian, Peep Laanmets, Willem Dewilde, Adam Witkowski, Jacques Monsegu, Andres Romo Iniguez, Majdi Halabi, Mamas A. Mamas, Ariel Roguin

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Aims: A substantial proportion of the patients undergoing percutaneous coronary intervention (PCI) have none of the of standard modifiable cardiovascular risk factors (SMuRFs): hypertension, diabetes, hypercholesterolaemia and smoking. The aim of this analysis was to compare clinical outcomes after PCI according to the number of SMuRFs. Methods: Patients with an indication for a PCI were stratified based upon the number of SMuRFs: 0, 1, 2 or 3–4. The primary outcome was target lesion failure (TLF), a composite of cardiac death, target vessel-related myocardial infarction or clinically driven target lesion revascularization at 1-year. Inverse weighted propensity score (IWPS) adjustment was performed to adjust for differences in baseline characteristics. Results: The prevalence of SMuRFs was: 0 SMuRF 16.4 %; 1 SMuRF 27.8 %; 2 SMuRFs 34.7 % and 3–4 SMuRFs 21.1 %. Patients without SMuRFs were younger, more likely to be male and had less complex coronary artery disease. The incidence of TLF increased with the number of SMuRFs: 2.65 %, 2.75 %, 3.23 %, and 4.24 %, Ptrend < 0.001. The relative risk (RR) for a TLF was 60 % higher (95 % confidence interval 1.32–1.93, p < 0.01) for patients with 3–4 SMuRFs compared to patients without SMuRFs. The trend remained (Ptrend < 0.01) after IWPS with TLF rates of 2.88 %, 2.64 %, 2.88 % and 3.65 %. The RR for a TLF was 27 % higher (95 % CI 1.05–1.53, p < 0.01). Conclusion: The incidence of clinical events at 1-year increased with the number of SMuRFs. While patients without SMuRFs have a relatively favourable risk profile, more research is needed to optimize therapeutic management in the majority of patients.

Original languageEnglish
Article number101370
JournalIJC Heart and Vasculature
Volume51
DOIs
StatePublished - Apr 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 The Author(s)

Funding

The e-Ultimaster registry was funded by Terumo Europe, Middle East & Africa (Leuven, Belgium).

FundersFunder number
Terumo Europe, Middle East & Africa

    Keywords

    • Clinical trial
    • Drug eluting stent
    • Human
    • Percutaneous coronary intervention
    • Risk factor

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