Back to Browse Journals » Vascular Health and Risk Management » Volume 8

Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients

Authors Reibis R, Treszl A, Wegscheider K, Bestehorn K, Karmann B, Voeller H

Published Date August 2012 Volume 2012:8 Pages 473—481

DOI http://dx.doi.org/10.2147/VHRM.S33305

Received 25 April 2012, Accepted 14 June 2012, Published 17 August 2012

Rona Reibis,1,2 Andras Treszl,3 Karl Wegscheider,3 Kurt Bestehorn,4 Barbara Karmann,4 Heinz Völler1,5

1
Department of Cardiology, Klinik am See, Rehabilitation Center of Cardiovascular Diseases, Rüdersdorf, 2Kardiologische Gemeinschaftspraxis am Park Sanssouci Potsdam, Potsdam, 3Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 4Medical Department, MSD Sharp and Dohme GmbH, Haar, 5Center of Rehabilitation Research, University of Potsdam, Potsdam, Germany

Background: There are few data available regarding the specificity and modifiability of major cardiovascular (CV) risk factors in patients with premature versus (vs) late-onset coronary artery disease (CAD). This study was designed to analyze and compare these risk factors.
Patients and 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.
Results: 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).
Conclusion: CV risk factors differ markedly between premature and non-premature CAD. Cardiac rehabilitation provides an opportunity to reinforce secondary prevention after acute coronary syndrome.

Keywords: acute coronary syndrome, premature manifestation, cardiovascular risk factors, diabetes, cholesterol

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Chloronychia: green nail syndrome caused by Pseudomonas aeruginosa in elderly persons

Chiriac A, Brzezinski P, Foia L, Marincu I

Clinical Interventions in Aging 2015, 10:265-267

Published Date: 14 January 2015

Characterization of hepatic enzyme activity in older adults with dementia: potential impact on personalizing pharmacotherapy

Campbell NL, Skaar TC, Perkins AJ, Gao S, Li L, Khan BA, Boustani MA

Clinical Interventions in Aging 2015, 10:269-275

Published Date: 14 January 2015

Cardiac allograft immune activation: current perspectives

Chang D, Kobashigawa J

Transplant Research and Risk Management 2015, 7:13-22

Published Date: 18 December 2014

Ex vivo and in vivo evaluation of an ultrasonic device for precise dissection, coagulation, and transection

Bertke BD, Scoggins PJ, Welling AL, Widenhouse TV, Chen C, Kallakuri S, Cavanaugh JM, Clymer JW, Amaral JF

Open Access Surgery 2015, 8:1-7

Published Date: 18 December 2014

Renal interstitial fibrosis induced by high-dose mesoporous silica nanoparticles via the NF-κB signaling pathway

Chen X, Zhouhua W, Jie Z, Xinlu F, Jinqiang L, Yuwen Q, Zhiying H

International Journal of Nanomedicine 2015, 10:1-22

Published Date: 18 December 2014

Transmyocardial revascularization devices: technology update

Kindzelski BA, Zhou Y, Horvath KA

Medical Devices: Evidence and Research 2015, 8:11-19

Published Date: 18 December 2014

Mipomersen and other therapies for the treatment of severe familial hypercholesterolemia

Bell DA, Hooper AJ, Watts GF, Burnett JR

Vascular Health and Risk Management 2012, 8:651-659

Published Date: 28 November 2012

Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level

Bestehorn K, Jannowitz C, Horack M, Karmann B, Halle M, Völler H

Vascular Health and Risk Management 2011, 7:639-647

Published Date: 31 October 2011

Learning curve for Lichtenstein hernioplasty

Mark Wiese, Thomas Kaufmann, Jürg Metzger, et al

Open Access Surgery 2010, 3:43-46

Published Date: 5 July 2010