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Published on: February 16, 2016
Age-Specific Cardiovascular Risk Factors for Major Adverse Cardiac Events in Patients Undergoing Myocardial Perfusion
Rosario Megna1, Mario Petretta2, Carmela Nappi3
1Institute of Biostructure and Bioimaging, National Council of Research, via T. De Amicis 95, 80145 Naples, Italy.
Insights
The risk of major adverse cardiac events (MACE) increases with age. Cardiovascular risk factors like diabetes and hypertension have age-specific prognostic impacts, highlighting the need for tailored risk assessment in coronary artery disease (CAD).
Area of Science:
- Cardiology
- Geriatrics
- Preventive Medicine
Background:
- Cardiovascular risk factors exhibit varying age-specific prevalence.
- The age-specific prognostic impact of these risk factors on coronary artery disease (CAD) remains unclear.
Purpose of the Study:
- To investigate age-specific patterns of cardiovascular risk factors.
- To evaluate the prognostic impact of these risk factors on CAD outcomes in relation to patient age.
Main Methods:
- 3667 patients with suspected or known CAD undergoing stress myocardial perfusion imaging (MPI) were analyzed.
- Risk for major adverse cardiac events (MACE) within three years was assessed across three age groups (<59, 59-68, >68 years).
- Multivariable Cox regression analyzed risk factors including demographics, comorbidities, and MPI outcome.
Main Results:
- Three-year MACE risk increased with age (9%, 13%, 18%; p < 0.0001).
- Dyspnea and abnormal MPI outcome were significant risk factors across all ages.
- Diabetes and smoking were significant from age 59+, while hypertension was significant >68 years.
Conclusions:
- The number of risk factors significantly correlates with increased MACE risk with advancing age.
- Myocardial perfusion imaging (MPI) results are valuable for risk stratification, whereas a personal history of CAD is not.
Background:
The prevalence of traditional cardiovascular risk factors shows different age-specific patterns. It is not known whether the prognostic impact of risk factors is similarly age-specific. We evaluated the profiles of cardiovascular risk factors and their prognostic impact on coronary artery disease (CAD) in relation to age.
Methods:
We included 3667 patients with suspected or known CAD undergoing stress myocardial perfusion imaging (MPI). We evaluated the risk for major adverse cardiac events (MACE) within three years from the index MPI in patients belonging to three groups according to age tertile distribution: <59, 59-68, and >68 years. Gender, body mass index, diabetes, hypertension, dyslipidemia, family history of CAD, smoking, angina, dyspnea, previous CAD, and MPI outcome were assessed as risk factors by a multivariable Cox's regression.
Results:
The three-year risk of MACE increased progressively with age and was 9%, 13%, and 18% for each group, respectively (p < 0.0001). Dyspnea and abnormal MPI outcome were significant risk factors for all age groups. Diabetes and smoking were significant from the age of 59 onwards, while hypertension resulted significant for patients older than 68 years.
Conclusions:
The number of risk factors was significantly associated with the occurrence of MACE increase with age. It is noteworthy that a personal history of CAD was not useful for risk stratification, while MPI results were.
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