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

Publication ,  Journal Article
Zeitouni, M; Clare, RM; Chiswell, K; Abdulrahim, J; Shah, N; Pagidipati, NP; Shah, SH; Roe, MT; Patel, MR; Jones, WS
Published in: J Am Heart Assoc
December 15, 2020

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.

Duke Scholars

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

December 15, 2020

Volume

9

Issue

24

Start / End Page

e017712

Location

England

Related Subject Headings

  • Stroke
  • Risk Factors
  • Retrospective Studies
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Myocardial Revascularization
  • Myocardial Infarction
  • Mortality, Premature
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Zeitouni, M., Clare, R. M., Chiswell, K., Abdulrahim, J., Shah, N., Pagidipati, N. P., … Jones, W. S. (2020). Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease. J Am Heart Assoc, 9(24), e017712. https://doi.org/10.1161/JAHA.120.017712
Zeitouni, Michel, Robert M. Clare, Karen Chiswell, Jawan Abdulrahim, Nishant Shah, Neha P. Pagidipati, Svati H. Shah, Matthew T. Roe, Manesh R. Patel, and W Schuyler Jones. “Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease.J Am Heart Assoc 9, no. 24 (December 15, 2020): e017712. https://doi.org/10.1161/JAHA.120.017712.
Zeitouni M, Clare RM, Chiswell K, Abdulrahim J, Shah N, Pagidipati NP, et al. Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease. J Am Heart Assoc. 2020 Dec 15;9(24):e017712.
Zeitouni, Michel, et al. “Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease.J Am Heart Assoc, vol. 9, no. 24, Dec. 2020, p. e017712. Pubmed, doi:10.1161/JAHA.120.017712.
Zeitouni M, Clare RM, Chiswell K, Abdulrahim J, Shah N, Pagidipati NP, Shah SH, Roe MT, Patel MR, Jones WS. Risk Factor Burden and Long-Term Prognosis of Patients With Premature Coronary Artery Disease. J Am Heart Assoc. 2020 Dec 15;9(24):e017712.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

December 15, 2020

Volume

9

Issue

24

Start / End Page

e017712

Location

England

Related Subject Headings

  • Stroke
  • Risk Factors
  • Retrospective Studies
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Myocardial Revascularization
  • Myocardial Infarction
  • Mortality, Premature
  • Middle Aged