Risk Factor Burden and Long‐Term Prognosis of Patients With Premature Coronary Artery Disease

Abstract

Background Coronary artery disease (CAD) is increasing among young adults. We aimed to describe the cardiovascular risk factors and long‐term prognosis of premature CAD. Methods and Results Using the Duke Databank for Cardiovascular Disease, we evaluated 3655 patients admitted between 1995 and 2013 with a first diagnosis of obstructive CAD before the age of 50 years. Major adverse cardiovascular events (MACEs), defined as the composite of death, myocardial infarction, stroke, or revascularization, were ascertained for up to 10 years. Cox proportional hazard regression models were used to assess associations with the rate of first recurrent event, and negative binomial log‐linear regression was used for rate of multiple event recurrences. Past or current smoking was the most frequent cardiovascular factor (60.8%), followed by hypertension (52.8%) and family history of CAD (39.8%). Within a 10‐year follow‐up, 52.9% of patients had at least 1 MACE, 18.6% had at least 2 recurrent MACEs, and 7.9% had at least 3 recurrent MACEs, with death occurring in 20.9% of patients. Across follow‐up, 31.7% to 37.2% of patients continued smoking, 81.7% to 89.3% had low‐density lipoprotein cholesterol levels beyond the goal of 70 mg/dL, and 16% had new‐onset diabetes mellitus. Female sex, diabetes mellitus, chronic kidney disease, multivessel disease, and chronic inflammatory disease were factors associated with recurrent MACEs. Conclusions Premature CAD is an aggressive disease with frequent ischemic recurrences and premature death. Individuals with premature CAD have a high proportion of modifiable cardiovascular risk factors, but failure to control them is frequently observed.

Sarcopenia predicts adverse outcomes in an elderly population with coronary artery disease: a systematic review and meta-analysis

“…Some risk factors for sarcopenia (i.e., type 2 diabetes, obesity, and inactivity) are also risk factors for coronary artery disease (CAD) [ 27 ]. Furthermore, type 2 diabetes, obesity, inactivity, reduced testosterone levels, malnutrition, and reduced growth factor levels are also factors for poor outcomes after a coronary event or after surgery [ 28 – 32 ]. Sarcopenia is associated with lower physical activity and respiratory muscle strength in patients with CAD [ 33 , 34 ].…”

Blood Plasma Serotonin and von Willebrand Factor as Biomarkers of Unstable Angina Progression Toward Myocardial Infarction

“…Enormous studies are dedicated to the issue of MI occurrence in IHD patients, particularly early MI diagnostic [15][16][17][18][19]. However, there is limited data regarding risk factors for UA transformation toward MI [20].…”

Calcification markers and long-term outcomes of coronary artery bypass grafting

“…керами. Часто фактором риска (ФР) прогрессирования КАс и неблагоприятного прогноза указывают СД [1], курение [2], семейную гиперхолестеринемию [4]. Известно, что с возрастом риск наличия отложений кальция в коронарных артериях увеличивается.…”

“…Оценке отдаленных результатов после КШ посвящено большое количество исследований. Значимыми факторами, влияющими на неблагоприятный прогноз, называют сахарный диабет (СД) [1], курение [2,3], семейную гиперхолестеринемию [4]. Анализируют также влияние пола и возраста на краткосрочную и долгосрочную выживаемость пациентов после КШ [5].…”