Coronary disease & ACSCohort study
First myocardial infarction: risk factors, symptoms, and medical therapy
- Retrospective cohort study
Authors' conclusion
In a large real-world dataset, half of the patients with first MI did not have documented antecedent symptoms, and approximately 1 in 5 had no previously identified SMuRFs. The majority of those who visited a physician prior to the MI with identified SMuRFs and symptoms were not using any preventive medical therapy.
Study context
- Population
- US patients ≥18 years with a first myocardial infarction (MI) (ICD-10), 1 January 2017 – 30 September 2022, Clarivate Real-World Data Product (linked EHR, medical and pharmacy claims)median age 70 years
- Participants
- 4,657,412 patients
- Outcome
- Prevalence of documented CAD risk factors (SMuRFs), documented symptoms, physician visits and preventive therapy uptake prior to first MI
- Follow-up
- Prior to first MI
Main finding
As reported in the abstract
Status prior to first MI · prior to MI
No documented symptoms
50.5%
No SMuRFs
18.0%
No documented physician visits
22.2%
Not prescribed any preventive therapy
63.4%
Observational data: associations, not effects.
Further findings
By age (≤60 vs >60 years) and sex (men vs women)
- Individuals ≤60 years and men less likely to have documented symptoms and SMuRFs, had fewer primary care physician visits, used less preventive therapy and had more frequent STEMI than individuals >60 years and women, respectively
Original publication
First myocardial infarction: risk factors, symptoms, and medical therapy. Eur Heart J. Published 3 July 2025. doi:10.1093/eurheartj/ehaf390
Summarised from the published abstract; every number is checked against it