Risk Perceptions and Discussions Before Acute MI

Oct 26, 2015
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Authors:
Leifheit-Limson EC, D’Onofrio G, Daneshvar M, et al.
Citation:
Sex Differences in Cardiac Risk Factors, Perceived Risk, and Health Care Provider Discussion of Risk and Risk Modification Among Young Patients With Acute Myocardial Infarction: The VIRGO Study. J Am Coll Cardiol 2015;66:1949-1957.
Summary By:
Elizabeth A. Jackson, MD, FACC

Study Questions:

Do cardiac risk factors and risk perceptions differ between young men and women?

Methods:

Data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute MI Patients) study were used for the present analysis. Patients (age 18-55 years) presenting with acute myocardial infarction (AMI) at 103 US and 24 Spanish hospitals between August 2008 and January 2012 were included. Data on risk factors (diabetes, dyslipidemia, hypertension, obesity, and smoking), self-perceived heart disease risk, and self-reported discussions of risk and risk modification were collected. Differences in these factors were examined by gender.

Results:

A total of 3,501 patients (2,349 women and 1,152 men, median age 48 years) were included in this analysis. The participants were predominately white. The majority of participants (98%) had ≥1 cardiovascular risk factors and 64% had ≥3 cardiovascular risk factors. However, only 53% of patients reported feeling that they were at risk for heart disease and 46% reported that they had been told by a provider that they were at risk for heart disease. Women were less likely than men to be told they were at risk for heart disease (relative risk [RR], 0.89; 95% confidence interval [CI], 0.84-0.96). Women were also less likely to have a discussion with their provider about risk factor modification (RR, 0.84; 95% CI, 0.79-0.89). Self-perceived risk for heart disease was similar between men and women.

Conclusions:

The authors concluded that despite the presence of significant cardiovascular risk factors, approximately one half of young patients with AMI thought they were at risk for heart disease prior to their MI. Few reported a discussion with their health care provider regarding their personal risk for heart disease or modification of cardiovascular risk.

Perspective:

These findings highlight the need to improve patients’ knowledge of their risk for heart disease and to help them understand how to modify this risk, even in young adulthood.

Keywords: Acute Coronary Syndrome, Cardiovascular Diseases, Diabetes Mellitus, Dyslipidemias, Female, Hypertension, Myocardial Infarction, Obesity, Primary Prevention, Risk, Risk Factors, Self Report, Smoking


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