Patients under age 40 may be at risk for premature coronary artery disease, Emory study shows

Patients under the age of 40 may be at risk for premature coronary artery disease (CAD), according to the results of a 15-year study conducted at Emory University. While CAD in young patients has not been studied as thoroughly as in older patients, the disease does present in this population, according to findings presented at the 50th annual meeting of the American College of Cardiology in Orlando. Joseph I. Miller III, M.D., Emory School of Medicine Fellow, presented the findings of his study at the American College of Cardiology (ACC) meeting March 19 in Orlando. Laurence Sperling, M.D. and William S. Weintraub, M.D., Emory School of Medicine cardiologists, were co-investigators in the study.

In all, 843 patients under the age of 40 with documented CAD were involved in the study. These participants were seen at Emory University between 1975 and 1985, and then they were followed for 15 years. The study was completed last year. It is the largest series published on documented atherosclerosis (hardening of the arteries) in this patient population. Because of the length of the follow-up, Emory researchers found a 30% death rate in this young patient population.

"Patients with a prior myocardial infarction (MI) or heart attack, weaker heart function and diabetes had a significantly higher mortality rate," says Dr. Miller of the 15-year follow-up in the study. "In our series, individuals who underwent revascularization (angioplasty or bypass surgery) had a lower mortality than those treated with just medications."

The study found that active tobacco use was a common risk factor for CAD and an important predictor of future mortality. Individuals who had stopped smoking for at least three months were at minimal increased risk during the 15 years of follow-up.

Dr. Miller says, "By identifying new predictors of CAD risk, we can identify and target patients and family members for aggressive screenings, treatments and early risk factor modifications."