Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA.
Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA.
Expert Rev Pharmacoecon Outcomes Res. 2021 Aug;21(4):559-570. doi: 10.1080/14737167.2021.1888718. Epub 2021 Feb 17.
: As the leading cause of death globally, atherosclerotic cardiovascular disease (ASCVD) carries substantial cost burden for patients and the healthcare system. Although overall mortality rates have recently decreased in certain groups, such improvements were not observed in younger ASCVD patients. This review focuses on premature ASCVD and explores risk factors affecting this younger cohort of patients.: We performed a literature search for studies assessing premature ASCVD, defined as ischemic heart disease (IHD), ischemic cerebrovascular disease (ICVD), or peripheral arterial disease (PAD) occurring in men aged ≤55 years and women aged ≤65 years.: Premature ASCVD patients often suffer from multiple traditional cardiovascular risk factors, in addition to genetic predisposition or unique non-traditional features, such as substance abuse and chronic inflammatory conditions. Consequently, identification and management of at-risk individuals pose a great challenge for clinicians. In this younger patient cohort, control of traditional risk factors, optimization of primary and secondary prevention therapies, and lifestyle modifications are imperative to saving potential disability-adjusted life years and other costs associated with premature atherosclerosis.
: 作为全球主要的死亡原因,动脉粥样硬化性心血管疾病(ASCVD)给患者和医疗系统带来了巨大的经济负担。尽管某些群体的总体死亡率最近有所下降,但年轻的 ASCVD 患者并未观察到这种改善。本综述重点关注早发性 ASCVD,并探讨了影响这一年轻患者群体的危险因素。
: 我们对评估早发性 ASCVD 的研究进行了文献检索,早发性 ASCVD 定义为男性年龄≤55 岁和女性年龄≤65 岁发生的缺血性心脏病(IHD)、缺血性脑血管病(ICVD)或外周动脉疾病(PAD)。
: 早发性 ASCVD 患者除了遗传易感性或独特的非传统特征(如滥用药物和慢性炎症性疾病)外,通常还患有多种传统心血管危险因素。因此,识别和管理高危人群对临床医生来说是一个巨大的挑战。在这个年轻的患者群体中,控制传统危险因素、优化一级和二级预防治疗以及生活方式的改变对于节省潜在的残疾调整生命年和与早发性动脉粥样硬化相关的其他成本至关重要。