Interplay of Age and Risk Factor Control Upon Coronary Atheroma Progression

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Atherosclerosis Research

Background:

• Coronary plaque progression varies with age, but the impact of risk factor control on this relationship is unclear.
• Atherosclerosis is a significant cause of cardiovascular disease, particularly in aging populations.
• Understanding age-related atheroma progression is key to refining cardiovascular risk assessment.

Purpose of the Study:

• To test if risk factor control modulates the association between patient age and coronary atheroma progression.
• To investigate the independent effect of age on the development of atherosclerotic plaque.
• To evaluate how well-controlled cardiovascular risk factors influence age-related changes in coronary plaque volume.

Main Methods:

• Pooled analysis of data from 10 prospective, randomized trials including 5,823 patients.
• Serial coronary intravascular ultrasonography (IVUS) was used to assess plaque volume.
• Percent atheroma volume (PAV) was calculated and analyzed in relation to age and risk factor control (LDL-cholesterol, SBP).

Main Results:

• Increasing age was independently associated with increased percent atheroma volume (PAV) progression (p<0.001).
• This association remained significant in patients with good risk factor control (LDL-cholesterol <1.8 mmol/L, SBP <130 mmHg).
• The effect of age on PAV progression was attenuated in patients with poorly controlled risk factors, becoming non-significant when both LDL-cholesterol and SBP were uncontrolled.

Conclusions:

• Patient age is a direct, independent predictor of coronary atheroma progression.
• Poor control of cardiovascular risk factors, specifically LDL-cholesterol and SBP, attenuates the influence of age on coronary artery disease progression.
• Effective risk factor management may mitigate age-related atheroma progression in cardiovascular disease.