National Cholesterol Education Panel III performance in preventing myocardial infarction in young adults

Only one published trial has directly evaluated the utility of the new National Cholesterol Education Program (NCEP) guidelines in young adults and that study population consisted of young Americans. We examined the utility of the latest NCEP Adult Treatment Panel III (ATP III) guidelines in a group of young Lebanese adults.

A group of 234 young adults admitted for myocardial infarction at a Lebanese teaching hospital over a 2-year period were evaluated retrospectively. The Framingham risk predictor model was used to calculate the 10-year risk for coronary events in all subjects.

Two hundred young Lebanese adults with a mean age of 49.7+/-7.6 years were included in the analysis. The majority of the study population had a history of smoking (67%) and LDL cholesterol <130 mg/dL (70.5%) and were considered overweight and obese (80.5%). As a group, 80% did not meet the criteria to qualify for antilipemic pharmacotherapy prior to their presentation.

The predictive model did not detect the majority of these patients. Clinicians should treat modifiable risk factors with the same intensity given to cholesterol even if the patient has a normal lipid profile.