STEMI patients are getting younger, more obese and more likely to have a chronic disease

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 - Heart

A retrospective analysis found that patients who presented at the Cleveland Clinic with STEMI in recent years were younger and more obese and were more likely to smoke or have hypertension, diabetes and chronic obstructive pulmonary disease (COPD) than those with STEMI in the 1990s.

The trends were similar among patients with a documented history of obstructive coronary artery disease.

Lead researcher Samir Kapadia, MD, the Cleveland Clinic’s section head for interventional cardiology, is  scheduled to present the results at the American College of Cardiology’s scientific session on April 4 in Chicago.

“On the whole, the medical community has done an outstanding job of improving treatments for heart disease, but this study shows that we have to do better on the prevention side,” Kapadia said in a news release. “When people come for routine checkups, it is critical to stress the importance of reducing risk factors through weight reduction, eating a healthy diet and being physically active.”

The researchers analyzed 3,914 patients with STEMI at the Cleveland Clinic between January 1995 and December 2014. Of the patients, 67.9 percent were males, 42.5 percent presented with anterior STEMI and 57.5 percent presented with inferior STEMI.

The mean age was 64 between 1995 and 1999, 62 between 2000 and 2004, 61 between 2005 and 2009, and 60 between 2010 and 2014. The prevalence of obesity was 31 percent, 37 percent, 38 percent and 40 percent, respectively, while the prevalence of diabetes was 24 percent, 25 percent, 24 percent and 31 percent.

Meanwhile, the prevalence of hypertension was 55 percent, 67 percent, 70 percent and 77 percent, while the prevalence of COPD was 5 percent, 9 percent, 11 percent and 12 percent, respectively.

The smoking prevalence was 28 percent, 32 percent, 42 percent and 46 percent. Among the general population, smoking prevalence declined during the 20-year period that the study examined.

The researchers added that there were no significant differences over the years with regards to gender, renal insufficiency, peripheral arterial disease, dyslipidemia and prior stroke prevalence.

The prevalence of STEMI patients presenting with three or more major risk factors increased from 65 percent to 85 percent during the study.

The researchers mentioned that people from rural areas were more likely to visit the Cleveland Clinic in recent years because the clinic transported patients via helicopters more often. However, they said that change would have no or little effect on the changing heart disease risk factors.

“Prevention must be kept in the forefront of primary care,” Kapadia said. “Cardiac health is not just dependent on the cardiologist. The primary care physicians and the patient need to take ownership of this problem.”