Control of standard modifiable cardiovascular risk factors before PCI may substantially influence long-term cardiovascular outcomes. A single-center observational study published in the European Heart Journal evaluated associations between preprocedural control of standard modifiable risk factors (SMuRFs) and 1-year cardiovascular outcomes after percutaneous coronary intervention (PCI).

The analysis included 19,651 patients who underwent PCI between 2012 and 2023. SMuRFs included hypertension, diabetes, hyperlipidemia, and smoking. Risk factor control was assessed using preprocedural blood pressure, glycemic measurements, low-density lipoprotein cholesterol levels, and smoking status. Patients were categorized according to the number of controlled risk factors (CRF): four, three, two, or one or fewer.

Findings

• Among the study population, 29.9% had four controlled risk factors, 41.7% had three, 22.5% had two, and 5.9% had one or fewer controlled risk factors.
• Compared with the 4-CRF group, patients with three controlled risk factors showed numerically higher MACE risk (adjusted HR 1.17; 95% CI 0.98–1.40).
• Patients with two controlled risk factors had significantly higher MACE risk (adjusted HR 1.39; 95% CI 1.14–1.69).
• Patients with one or fewer controlled risk factors showed the highest observed MACE risk (adjusted HR 1.48; 95% CI 1.10–2.00).
• Glycemic control demonstrated the strongest association with lower MACE risk among individual SMuRFs (adjusted HR 0.56; 95% CI 0.49–0.65).

The findings suggest that more comprehensive SMuRF control before PCI corresponded with lower rates of adverse cardiovascular events during follow-up. Glycemic control showed the strongest association with improved post-PCI outcomes.