Coronary Artery Disease Prevalence in an Executive Population at a Tertiary Medical Center: Protocol for a Retrospective Cohort Study.

Abstract

Background: Coronary artery disease (CAD) is a leading cause of global morbidity and mortality. Although CAD prevalence in the general population is well-documented, its occurrence among executive patients remains largely unexplored. An executive is an individual in a major leadership role, such as a C-suite officer, senior manager, board member, trustee, founder, or business owner, responsible for high-level decision-making and strategic direction. These roles often involve demanding schedules and significant stress. Despite their influence and better access to health care, this demographic faces unique challenges such as demanding work schedules, chronic stress, frequent travel, and reduced control over lifestyle. To address executives' unique health needs, many health care organizations offer specialized programs emphasizing preventive cardiovascular care, using advanced tools such as lipid panels, stress tests, and coronary calcium scans not typically included in primary care, to detect risks early and to promote long-term wellness.

Objective: This protocol aims to design a study to determine the prevalence of CAD in executive patients and compare it to the established prevalence in the US general population with the overarching goal of improving screening and care of CAD among executive patients.

Methods: This protocol proposes a retrospective review of medical records for patients with CAD seen at the Mayo Clinic's Executive Health Program from January 1, 2020, to December 31, 2023, with the aim of determining the prevalence of CAD in executive patients. The primary outcome is CAD prevalence, which will be identified through clinical diagnoses in the electronic medical records. Secondary outcomes include demographics, cardiovascular medications, social determinants of health, laboratory and diagnostic results, coronary calcium scores, and treatment interventions. The prevalence of CAD will be calculated as the proportion of patients with a documented CAD diagnosis relative to the total number of patients in the study cohort.

Results: A total of 24,272 patients were seen in the executive health clinic between January 1, 2020, and December 31, 2023. After applying the inclusion criteria, 6466 executive patients were eligible, with 3290 identified as having a potential CAD diagnosis pending confirmation through a detailed chart review.

Conclusions: In this protocol, we outline a research design and methodology to address a critical gap in understanding the prevalence of CAD among executive patients. This demographic is often overlooked despite their unique risk factors such as high stress and lifestyle choices.

International registered report identifier (irrid): DERR1-10.2196/72451.