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Angiographic and coronary risk factor analyses of Japanese patients with ischemic heart disease before age 40--a
11st Department of Medicine, Dokkyo University School of Medicine, Tochigi, Japan.
Insights
Younger patients with ischemic heart disease (IHD) show predominantly single-vessel disease. These patients exhibit significantly higher prevalence of coronary risk factors like smoking and hypercholesterolemia compared to controls.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Ischemic heart disease (IHD) typically affects older individuals.
- Understanding IHD in younger populations is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To analyze coronary angiographic and risk factor (RF) characteristics in Japanese patients with IHD under 40 years old.
- To compare these characteristics with older controls and age-matched volunteers.
Main Methods:
- Coronary angiography (CAG) data from 133 Japanese patients (<40 years) with IHD were analyzed.
- Comparison with 216 older controls (>40 years) with coronary sclerosis and 133 younger, sex- and age-matched volunteers.
Main Results:
- Zero- or single-vessel disease predominated in younger IHD patients (77% coronary sclerosis).
- Younger patients had significantly higher incidences of smoking (83%), hypercholesterolemia (44%), obesity (31%), hypertension (29%), familial IHD (28%), and diabetes mellitus (19%) compared to younger controls.
- Multivessel disease was less common in younger patients than older controls.
Conclusions:
- Younger IHD patients present with distinct angiographic patterns (predominantly single-vessel disease).
- A significantly higher prevalence of major coronary risk factors is observed in young IHD patients, highlighting the importance of early risk factor modification.
Abstract:
Coronary angiographic and risk factor (RF) characteristics were analyzed in 133 Japanese patients with ischemic heart disease (IHD) who were less than 40 years old and who had undergone coronary angiography (CAG) during the past 10 years at six university hospitals in the Tokyo area. We compared the coronary angiographic characteristics of the subject group with those of 216 controls with coronary sclerosis detected by CAG who were more than 40 years old (older control group) and the RF characteristics with those of 133 sex- and age-matched volunteers (younger control group). Sixty seven percent of the subjects (89 cases) were diagnosed as having myocardial infarction (MI) and 33% (44 cases) had angina pectoris (AP). Coronary artery disorders in this group consisted of 103 (77%) cases of coronary sclerosis, 20 (15%) cases of coronary spasm and 10 (8%) cases of miscellaneous diseases, eg, possible vasculitis with connective tissue disease, congenital anomalies, etc. The incidences of significant (> or = 75%) sclerotic narrowing in 0 vessels (31%) and 1 vessel (49%) in the subject group were significantly (p < 0.01) higher than those in the older control group, while the incidence of multivessel disease was significantly (p < 0.05) less in the subject group than in the older control group. The incidences of the following coronary risk factors were significantly (p < 0.05) higher in the subjects than in the younger controls: smoking (83% vs 35%), hypercholesteremia (44% vs 10%), obesity (31% vs 9%), hypertension (29% vs 3%), familial IHD (28% vs 7%) and diabetes mellitus (19% vs 2%). Thus, zero- or single-vessel disease predominated in the younger subject group and the prevalence of coronary risk factors was significantly higher in the subject.