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Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients Full Text
Vascular Health and Risk Management, 08/21/2012
Reibis R et al. – Cardiovascular (CV) risk factors differ markedly between premature and non–premature coronary artery disease (CAD). Cardiac rehabilitation provides an opportunity to reinforce secondary prevention after acute coronary syndrome.
Methods- Data from 15,381 consecutive patients (mean age, 62.3 ± 11.7 years; female, 33.8%) hospitalized with CAD were collected from a large–scale registry (Transparency Registry to Objectify Guideline–Oriented Risk Factor Management) and analyzed.
- The patients were divided into two groups, depending on age at inclusion: group 1 patients (n = 5725; mean age, 50.5 ± 7.2 years) were males aged < 55 years and females aged < 65 years; group 2 patients (n = 9656; mean age, 69.4 ± 7.4 years) were males aged > 55 years and females aged > 65 years and had a low–density lipoprotein cholesterol level of >100 mg/dL on admission to cardiac rehabilitation.
- Besides the conventional risk factors, lipoprotein(a) concentrations and glucose tolerance were measured facultatively.
- Univariate (chi–square test) and multivariate logistic regression models were used.
- Cigarette smoking (group 1 at 31.5% vs group 2 at 9.4%; P < 0.001), family history of CAD (group 1 at 43.6% vs group 2 at 26.5%; P < 0.001), and dyslipidemia (group 1 at 92.7% vs group 2 at 91.8%; P < 0.001) were dominant risk factors in the younger group.
- Arterial hypertension (group 1 at 71.4% vs group 2 at 87.0%; P < 0.001) and diabetes (group 1 at 23.5% vs group 2 at 30.1%; P < 0.001) were dominant risk factors in the older group.
- Impaired glucose tolerance and diabetes were less frequent in the younger group (Ptrend = 0.038), and identical lipoprotein(a) concentration levels of >30 mg/dL were found in both groups (8.0%; P = 0.810).
- Modification of lipid profile and blood pressure was more effective in the younger group (low–density lipoprotein cholesterol < 100 mg/dL: group 1 at 66.3% vs group 2 at 61.1%; systolic blood pressure < 140 mmHg: group 1 at 91.7% vs group 2 at 83.0%; P < 0.001).