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Evolution and Outcomes of Premature Coronary Artery Disease

  • Ischemic Heart Disease (D Mukherjee, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to explore the evolution and outcomes of premature coronary artery disease (PCAD) while reviewing strategies for effective screening of those at high risk for developing this disease.

Recent Findings

Premature coronary artery disease (PCAD) affects a population of patients not typically identified as high risk by current risk stratification guidelines or traditional risk calculation tools. Not only does PCAD represent a large proportion of overall cardiovascular disease, it also afflicts a population in which the rate of mortality from cardiovascular disease has plateaued despite an overall declining population-wide cardiovascular mortality rate. There is ample opportunity for behavioral change strategies, screening tools, adapted imaging modalities, and precision pharmacotherapies to be more precisely targeted toward those at highest risk for premature coronary artery disease.

Summary

Premature coronary artery disease (PCAD) is pervasive and not frequently represented within contemporary risk calculation models. Providers should pursue proactive screening and aggressive risk factor modification and deploy appropriate preventative therapies in caring for younger populations.

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Abbreviations

PCAD:

Premature coronary artery disease

CAD:

Coronary artery disease

MACE:

Major adverse cardiovascular events

EAPC:

Estimated annual percentage change

OMT:

Optimal medical therapy

LDL:

Low-density lipoprotein

USPSTF:

United States Preventative Services Task Force

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Authors and Affiliations

  1. Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Cara Lea Smith

  2. Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Matthew Seigerman, Srinath Adusumalli, Jay Giri, Paul N. Fiorilli, Daniel M. Kolansky & Taisei Kobayashi

  3. Cardiovascular Outcomes, Quality and Evaluative Research Center, The University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Srinath Adusumalli, Jay Giri, Paul N. Fiorilli & Taisei Kobayashi

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  1. Cara Lea Smith
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Correspondence to Taisei Kobayashi.

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Dr. Giri has served on advisory boards for AstraZeneca and Inari Medical and has received research funds to institution from Boston Scientific and St. Jude Medical. The other authors have no relevant conflicts of interest to disclose.

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Smith, C.L., Seigerman, M., Adusumalli, S. et al. Evolution and Outcomes of Premature Coronary Artery Disease. Curr Cardiol Rep 23, 36 (2021). https://doi.org/10.1007/s11886-021-01457-8

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