Juan-Salvadores Pablo, Jiménez Díaz Víctor Alfonso, Iglesia Carreño Cristina, Guitián González Alba, Veiga Cesar, Martínez Reglero Cristina, Baz Alonso José Antonio, Caamaño Isorna Francisco, Iñiguez Romo Andrés
Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, 36213 Vigo, Spain.
Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, Universidade de Vigo, 36213 Vigo, Spain.
J Cardiovasc Dev Dis. 2022 Mar 11;9(3):82. doi: 10.3390/jcdd9030082.
Coronary artery disease (CAD) is a common chronic condition in the elderly. However, the earlier CAD begins, the stronger its impact on lifestyle and costs of health and social care. The present study analyzes clinical and angiographic features and the outcome of very young patients undergoing coronary angiography due to suspected CAD, including a nested case-control study of ≤40-year-old patients referred for coronary angiography. Patients were divided into two groups: cases with significant angiographic stenosis, and controls with non-significant stenosis. Of the 19,321 coronary angiographies performed in our center in a period of 10 years, 504 (2.6%) were in patients ≤40 years. The most common cardiovascular risk factors for significant CAD were smoking (OR 2.96; 95% CI 1.65-5.37), dyslipidemia (OR 2.18; 95% CI 1.27-3.82), and family history of CAD (OR 1.95; 95% CI 1.05-3.75). The incidence of major adverse cardiovascular events (MACE) at follow-up was significantly higher in the cases compared to controls (HR 2.71; 95% CI 1.44-5.11). Three conventional coronary risk factors were directly related to the early signs of CAD. MACE in the long-term follow-up is associated to dyslipidaemia and hypertriglyceridemia. Focusing efforts for the adequate control of CAD in young patients is a priority given the high socio-medical cost that this disease entails to society.
冠状动脉疾病（CAD）是老年人常见的慢性疾病。然而，CAD发病越早，对生活方式以及健康和社会护理成本的影响就越大。本研究分析了因疑似CAD接受冠状动脉造影的非常年轻患者的临床和血管造影特征及预后，包括对年龄≤40岁接受冠状动脉造影的患者进行的一项巢式病例对照研究。患者分为两组：血管造影有显著狭窄的病例组和无显著狭窄的对照组。在我们中心10年内进行的19321例冠状动脉造影中，504例（2.6%）是年龄≤40岁的患者。显著CAD最常见的心血管危险因素是吸烟（比值比2.96；95%置信区间1.65 - 5.37）、血脂异常（比值比2.18；95%置信区间1.27 - 3.82）和CAD家族史（比值比1.95；95%置信区间1.05 - 3.75）。随访时，病例组主要不良心血管事件（MACE）的发生率显著高于对照组（风险比2.71；95%置信区间1.44 - 5.11）。三种传统的冠状动脉危险因素与CAD的早期迹象直接相关。长期随访中的MACE与血脂异常和高甘油三酯血症有关。鉴于这种疾病给社会带来的高昂社会医疗成本，优先致力于对年轻患者的CAD进行充分控制。
