Artery Disease In Young Adults Research Articles

Associations of circulating adipokines and coronary artery disease in young adults

Aim. To evaluate the associations of abdominal obesity (AO), adipokines and premature coronary artery disease (CAD) in young people for a deeper understanding of the pathogenesis of atherosclerotic diseases.Material and methods. A total of 1457 people were examined, including 653 (44,8%) men. Mean age was 36,7±6,0 years. Premature CAD was detected in 46 people, while 4 following subgroups were formed (138 people in total): with CAD and AO; with CAD, without AO; control groups by age and sex: without CAD, with AO; without CAD, without AO.Results. Premature CAD in young people is associated with an increase in non-high-density lipoprotein cholesterol (non-HDL-C). Univariate analysis found that the probability of CAD increased by 1% with an increase in adiponectin level, and by 0,2% with an increase of 1 ng/ml in resistin level. Multivariate regression analysis, including sex, age, waist circumference, non-HD-C, adiponectin, and resistin, significant associations were obtained for non-HDL-C and adiponectin. With AO, the CAD probability increased by 0,6% with an increase in plasminogen activator inhibitor-1 level (PAI-1). However, when non-HDL-C was included in the model, significance for this biomarker was not achieved.Conclusion. In young people, CAD is associated with increased levels of non-HDL cholesterol, adiponectin, resistin and PAI-1. Independent associations with premature CAD were obtained only for adiponectin, which makes this marker promising for study in young people.

Prospective bidirectional relations between depression and metabolic health: 30-year follow-up from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study.

This study investigated prospective bidirectional relationships between depressive symptoms and metabolic syndrome (MetS) and the moderating effects of race, sex, and health behaviors in a diverse cohort followed for 30 years. Data were analyzed from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study, a 30-year prospective study of young adults (N = 5,113; Mage = 24.76 [SD = 3.63] at baseline; 45% male) who were tested every 5 years between 1985 and 2015. Measures included biological assessments of MetS components and self-reported depressive symptoms based on the Center for Epidemiologic Studies Depression (CESD) scale. Data analyses included bidirectional general estimating equations analyses of time-lagged associations between depressive symptoms and MetS. There was a consistent, bidirectional relationship between depressive symptoms and MetS over time. Individuals with more CESD depressive symptoms were more likely to develop MetS over time compared to those reporting fewer symptoms, Wald χ²(1) = 7.09, p < .008, and MetS was similarly predictive of CESD. MetS more consistently predicted CESD scores at each 5-year exam than CESD predicted MetS. Race and sex moderated these relationships, with White females, White individuals overall, and females overall demonstrating significant relationships between CESD depressive symptoms and MetS. Health behaviors were not related to associations between CESD and MetS. In a diverse young adult population prospectively followed into late middle age, MetS more consistently predicted depressive symptoms over time than depressive symptoms predicted MetS. The relation between MetS and depressive symptoms was moderated by race and sex, but not health behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Coronary Angiographic Characteristic of Coronary Artery Disease of Young Adults Under Age Forty Years Compare to Those Over Age Forty

This study aimed to compare the coronary angiographic characteristics of coronary artery disease in young adults (≤40 years) and older adults (&gt;40 years). This was a retrospective analytic study. The study was conducted at the Department of Cardiology, Rajshahi Medical College Hospital. 100 patients with coronary artery disease were included in this study. Among the 100 patients, 50% were in the ≤40 years’ group (group A) and 50% were in the &gt;40 years’ group (group B). Coronary angiographic characteristics were analyzed for each group. Coronary artery disease was present in 72% of group A and 84% of group B. In group A, single vessel disease (SVD) was the most common pattern (38%, p=0.001), while in group B, double vessel disease (DVD) (36%, p=0.043), triple vessel disease (TVD) (26%, p=0.033), and left main vessel disease (LM) (8%, p=0.035) were more prevalent. Left ventricular dysfunction with hypokinesia was observed in the majority of patients. The left anterior descending (LAD) artery was most commonly involved in both groups, primarily in the mid and proximal segments. The right coronary artery (RCA) was the next commonly affected artery, with differences in involvement site between the two groups. This study highlights that SVD is more common among young adults, whereas DVD, TVD, and LM diseases are more prevalent in older individuals. Older age groups exhibited a higher prevalence of diabetes mellitus, while smoking, dyslipidemia, and hypertension were common risk factors for coronary artery disease in both age groups. TAJ 2023; 36: No-2: 01-09

Supplemental Material for Prospective Bidirectional Relations Between Depression and Metabolic Health: 30-Year Follow-Up From the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) Study

Supplemental Material for Prospective Bidirectional Relations Between Depression and Metabolic Health: 30-Year Follow-Up From the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) Study

CORRELATION OF SEVERITY OF CORONARY ARTERY DISEASE WITH LIPOPROTEIN A LEVEL IN YOUNG ADULTS

Objectives: To address the association between Lipoprotein (a) and coronary artery disease risk in young patients &amp; to evaluate whether high levels of lipoprotein (a) is a predictor of risk and is related to the severity of coronary artery disease.&#x0D; Methodology: This retrospective study was carried out at Cardiology Deptt of Hayatabad Medical Complex Peshawar between June and December 2021. Total 160 patients referred to the cardiac catheterization lab of either gender, aged 20-45 years who underwent coronary angiography for various clinical indications were enrolled in the study. Lipoprotein (a) level, lipid profile, fasting blood glucose, anthropometric and clinical parameters of the patients were analyzed.&#x0D; Results: Statistically significant differences were observed in the mean of serum lipoprotein (a) concentrations between group “A” (58.6 ± 3.20 mg/ dl) and group “B” (19.6+0.10 mg/ dl) P value &lt;0.001. Mean HDL was 32.6 ± 0.30 in group “A” and in group B it was 40.4 ± 0.39 (p value &gt;0.005), total cholesterol was 199 ± 2.00 in group “A” &amp; 152 ± 1.80 in group “B” (p value &lt;0.005), triglycerides (TGL) in group “A” (182.76 ± 43.86 mg/dl) &amp; in group “B” (124.14 ± 44.01 mg/dl) P value &lt;0.001, LDL in group “A” was (130±4.28 &amp; in group “B” (84.4±3.00) p value &lt;0.001, VLDL between group “A” (36.03 ± 9.19mg/dl) and group B (24.68 ± 8.89 mg/dl) P value &gt; 0.003. However total Cholesterol / HDL was significantly lower in group “B” 3.5 as compared to group “A” 5.8 P value &lt; 0.002.&#x0D; Conclusion: Irrespective of other traditional risk factors, increase in Lipoprotein (a) is an independent risk factor for coronary artery disease in young adults with positive family history. Thus elevated levels of Lipoprotein (a) may serve as an important criterion to identify the individuals who need to undergo lipoprotein (a) lowering treatment, thereby preventing them from myocardial infarction.

Racial disparities in ventricular tachycardia in young adults: analysis of national trends.

In the last two decades, risk factors, prevalence, and mortality due to coronary artery disease in young adults are on the rise. We sought to assess the prevalence, trends, and economic burden of ventricular tachycardia (VT) hospitalizations in young adults (< 45years), further stratified by race and gender. The Nationwide Inpatient Sample was explored for hospitalizations with VT in patients (< 45years) between 2005 and 2018 and divided among 3 groups of the quadrennial period using validated International Classification of Diseases (ICD) 9th and 10th revision Clinical Modification (CM) codes. The Pearson chi-square test and Wilcoxon rank-sum were used for categorical and continuous variables, respectively. We assessed the temporal trends of mortality in VT hospitalizations and trends of VT hospitalization stratified by age, sex, and race by using Joinpoint regression analysis. The primary outcome was in-hospital mortality trends. Secondary outcomes were trends of hospital stay in days, cost of care in US dollars, cardiac arrest, and discharge disposition. Out of 5,156,326 patients admitted with VT between 2005 and 2018, 309,636 were young adults. Among them, 102,433 were admitted between 2005 and 2009 (mean age 36.1 ± 6.99; 61% male, 58.5% White), 109,591 between 2010 and 2014 (mean age 35.5 ± 7.16; 59% male, 54.2% White), and 97,495 between 2015 and 2018 (mean age 35.4 ± 7.00; 60% male, 52.3% White) (p < 0.07). In the young adults with VT, all-cause mortality was 7.37% from 2005 to 2009, 7.85% from 2010 to 2014 (6.5% relative increase from 2005 to 2009), and 8.98% from 2015 to 2018 (relative increase of 14.4% from 2010 to 2014) (p < 0.0001). Similarly, risk of cardiac arrest was on the rise (6.15% from 2005 to 2009 to 7.77% in 2010-2014 and 9.97% in 2015-2018). Inflation-adjusted cost increased over the years [$12,177 in 2005-2009; $13,249 in 2010-2014; $15,807 in 2015-2018; p < 0.0001)]. VT hospitalizations and related all-cause mortality, and healthcare utilization costs in young adults are on the rise in the study period. Hospitalization burden related to VT and poor outcomes were more notable for Black adults. Further studies are required for targeted screening and preventative measures in young adults.

Associations between weight discrimination and metabolic health: A cross sectional analysis of middle aged adults

BackgroundConcurrent with the recent rise in overweight and obesity, concerns with weight discrimination have arisen. Individuals who have experienced weight discrimination report a host of deteriorations related to physical and psychological health, which may co-exist with behaviours such as increased food consumption and decreases in physical activity that make weight management difficult. What remains less clear, however, is the extent to which metabolic health may be specifically affected, and how this may vary by setting and perceived intensity of the lifetime history of weight discrimination. MethodTo address this, a secondary data analysis was performed on 1365 participants from year 25 of the Coronary Artery Disease in Young Adults (CARDIA) study who were living with overweight and obesity. Descriptive statistics and logistic regression analyses were performed on the presence of metabolic syndrome, diabetes, and abdominal obesity, as well as their experience of the weight discrimination. ResultsPrevalence of the metabolic syndrome, diabetes, and abdominal obesity was higher among those reporting low and high stress weight discrimination compared to those with no history of weight discrimination. In the adjusted analyses, weight discrimination was associated with a 65% greater likelihood for having metabolic syndrome, 85% greater likelihood of diabetes, and between a 2.5- and 3.9-times greater likelihood of abdominal obesity for low and high stress experiences, respectively. ConclusionExposure to weight discrimination may worsen metabolic health, as characterized by higher rates of metabolic syndrome and abdominal obesity. These associations may be greater with levels of stress experienced from weight discrimination. Further longitudinal work is necessary to understand the temporal sequence, time lag, and any possible critical periods for weight discrimination on metabolic health.

Nomogram for Predicting the Severity of Coronary Artery Disease in Young Adults ≤45 Years of Age with Acute Coronary Syndrome

Background: A non-invasive predictive model has not been established to identify the severity of coronary lesions in young adults with acute coronary syndrome (ACS). Methods: In this retrospective study, 1088 young adults (≤45 years of age) first diagnosed with ACS who underwent coronary angiography were enrolled and randomized 7:3 into training or testing datasets. To build the nomogram, we determined optimal predictors of coronary lesion severity with the Least Absolute Shrinkage and Selection Operator and Random Forest algorithm. The predictive accuracy of the nomogram was assessed with calibration plots, and performance was assessed with the receiver operating characteristic curve, decision curve analysis and the clinical impact curve. Results: Seven predictors were identified and integrated into the nomogram: age, hypertension, diabetes, body mass index, low-density lipoprotein cholesterol, mean platelet volume and C-reactive protein. Receiver operating characteristic analyses demonstrated the nomogram’s good discriminatory performance in predicting severe coronary artery disease in young patients with ACS in the training (area under the curve 0.683, 95% confidence interval [0.645–0.721]) and testing (area under the curve 0.670, 95% confidence interval [0.611–0.729]) datasets. The nomogram was also well-calibrated in both the training (P=0.961) and testing (P=0.302) datasets. Decision curve analysis and the clinical impact curve indicated the model’s good clinical utility. Conclusion: A simple and practical nomogram for predicting coronary artery disease severity in young adults≤45 years of age with ACS was established and validated.

Abstract 13548: Ventricular Tachycardia: National Trends Among Young: A Public Health Alert

Introduction: In the last two decades, risk factors, prevalence, and mortality due to coronary artery disease in young adults is on the rise. Hypothesis: Assess the prevalence, trends, and economic burden of ventricular tachycardia (VT) in young adults (18-44 years). Methods: The Nationwide Inpatient Sample was explored for hospitalizations with VT in patients (Age 19-44) between 2005-2018 and divided among 3 groups of the quadrennial period using validated ICD-9 and ICD-10 CM codes. The Pearson chi-square test and Student’s t-test were used for categorical and continuous variables, respectively. We assessed the temporal trends of mortality in VT as well as trends of VT stratified by age, sex, and race by the linear-by-linear association test (Figure 1). Results: Out of 5,156,326 patients were admitted with VT between 2005-2018, 309,636 were in young adults. Among them, 102,433 were admitted between 2005-2009 (mean age 36.1±6.99; 61% male, 58.5% white), 109,591 between 2010-2014 (mean age 35.5±7.16; 59% male, 54.2% white), and 97,495 between 2015-2018 (mean age 35.4±7.00; 60% male, 52.3% white) (p&lt;0.0001). In the young adults with VT, all-cause mortality was 7.37% from 2005-2009, 7.85% from 2010-2014 (6.5% relative increase from 2005-2009), and 8.98% from 2015-2018 (relative increase of 14.4% from 2010-2014) (p&lt;0.0001). Inflation adjusted cost increased over the years [$12,177 in 2005-2009; $13,249 in 2010-2014; $15,807 in 2015-2018; p&lt;0.0001)]. Conclusions: The prevalence of VT in young individuals is rising. VT-related mortality and healthcare utilization costs are on the rise in the study period. VT burden and poor outcomes were notable for Black males. Further studies are required for targeted screening and preventative measures in young adults.

Combined effect of hyperhomocysteinemia and smoking on the severity of coronary artery disease in young adults\u2009\u2264\u200935\xa0years of age: a hospital-based observational study

BackgroundThe prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain.MethodsWe consecutively collected young patients (18–35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis.ResultsA total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141–0.462; P < 0.001) and pack-years of smoking (β 0.523; 95% CI 0.265–0.781; P < 0.001) were independently associated with the severity of coronary artery stenosis after adjusting for other traditional confounders. In addition, serum Hcy levels were correlated with pack-years of smoking in young CAD patients (r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314–24.469; P < 0.001), compared with HHcy (β 7.471; 95% CI 0.009–14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608–14.233; P = 0.033) alone.ConclusionCombination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age.

Donor Family History of ESKD and Long-term Outcomes Among African American Living Kidney Donors: A Retrospective Cohort Study

Rationale & ObjectiveLive kidney donation is associated with a small increased risk for kidney disease and hypertension in African American donors. We investigated a possible association between donor family history of end-stage kidney disease (ESKD) and their postdonation kidney function and the development of hypertension. We tested whether this association was modified by kidney donation.Study DesignRetrospective cohort.Setting & ParticipantsFormer African American live kidney donors between 1993 and 2010. Healthy nondonors were selected from the Coronary Artery Disease in Young Adults (CARDIA) Study.ExposureFamily history of ESKD in a first-degree relative.OutcomesKidney function and blood pressure ≥ 140/90 mm Hg or use of antihypertensive medications at follow-up.Analytical ApproachDonors were grouped based on family history of ESKD. Outcomes were first compared between donor groups and then between donors and healthy nondonors matched for demographics, follow-up time, and family history. A mixed-effect model was used to compare outcomes.ResultsOf 179 donors, 139 (78%) had a first degree relative with ESKD. Predonation characteristics were similar between the 2 groups. At a median follow-up of 11 years postdonation, there was no difference in postdonation estimated glomerular filtration rates (68 ± 19 vs 69 ± 13 mL/min/1.73 m2; P = 0.71) and the presence of albuminuria (P = 0.16). There was a trend toward a higher incidence of hypertension (51% vs 35%; P = 0.08) among donors with a family history of ESKD than for those without. Although there was no difference in annual change in estimated glomerular filtration rate (P = 0.17), the risk for hypertension was higher in donors than nondonors (relative risk, 2.44 [95% CI, 1.56-3.84]), but there was no interaction by family history (P = 0.11).LimitationsRetrospective small study. Lack of data across donor-recipient specific biological relationship.ConclusionsFamily history of ESKD is not associated with postdonation kidney function among African American kidney donors. Live kidney donation is associated with an increased risk for hypertension among African Americans, independent of donor family history of ESKD.

Shear stress induced activation of von Willebrand factor may facilitate thrombotic events in coronary artery disease in young adults

Shear stress induced activation of von Willebrand factor may facilitate thrombotic events in coronary artery disease in young adults

Marijuana use and coronary artery disease in young adults.

Marijuana is the most popular drug of abuse in the United States. The association between its use and coronary artery disease has not yet been fully elucidated. This study aims to determine the frequency of coronary artery disease among young to middle aged adults presenting with chest pain who currently use marijuana as compared to nonusers. In this retrospective study, 1,420 patients with chest pain or angina equivalent were studied. Only men between 18 and 40 years and women between 18 and 50 years of age without history of cardiac disease were included. All patients were queried about current or prior cannabis use and underwent coronary CT angiography. Each coronary artery on coronary CT angiography was assessed based on the CAD-RADS reporting system. A total of 146 (10.3%) out of 1,420 patients with chest pain were identified as marijuana users. Only 6.8% of the 146 marijuana users had evidence of coronary artery disease on coronary CT angiography. In comparison, the rate was 15.0% among the 1,274 marijuana nonusers (p = 0.008). After accounting for other cardiac risk factors in a multivariate analysis, the negative association between marijuana use and coronary artery disease on coronary CT angiography diminished (p = 0.12, 95% CI 0.299-1.15). A majority of marijuana users were younger than nonusers and had a lower frequency of hypertension and diabetes than nonusers. There was no statistical difference in lipid panel values between the two groups. Only 2 out of 10 marijuana users with coronary artery disease on coronary CT angiography had hemodynamically significant stenosis. Among younger patients being evaluated for chest pain, self-reported cannabis use conferred no additional risk of coronary artery disease as detected on coronary CT angiography.

Assessment of the Reynolds Risk Score and Correlation of Levels of Inflammatory Cardiac Biomarkers with Angiographic Severity of Coronary Artery Disease in Young Adults

Assessment of the Reynolds Risk Score and Correlation of Levels of Inflammatory Cardiac Biomarkers with Angiographic Severity of Coronary Artery Disease in Young Adults

Sudden cardiac arrest related to coronary artery disease in young adults

Considering major shifts in coronary artery disease (CAD) epidemiology over the last two decades, we hypothesized that CAD was probably henceforth the main etiology of sudden cardiac arrest (SCA) among young adults. To describe burden and features of CAD-related SCA in young (≤ 40 year-old) adults using a contemporary community-based study. From May 2011 to 2016, all cases of SCA admitted alive across 48 hospitals of the Greater Paris Area were prospectively enrolled and young SCA (< 40 years) specifically assessed. Cardiovascular causes of SCA were determined from medical reports with central adjudication. Out of 18,662 out-of-hospital cardiac arrests, 3028 SCA were admitted alive, with 353 (11.7%) being ≤ 40 year-old (32.1 ± 6.2 year-old, 70.8% males). Among the 1,557 (51.4%) patients with an established cardiac cause, 142 (9.1%) were aged less than 40-years. CAD accounted for 58 (40.8%) cases, whereas non-ischemic heart disease and non-structural heart disease for 52 (36.6%) and 32 (22.5%), respectively. Within the 30–40 year age group, CAD represented 53.7% of all diagnoses. While 86.2% of CAD-related young SCA was due to an acute coronary syndrome (ACS), rate of immediate coronary angiography at hospital admission was only 39.2% compared to 63.4% among those > 40-years (OR = 0.38, 95% CI: 0.27–0.53, P < 0.001), and remained associated with survival at hospital discharge (OR = 4.18, 95% CI: 1.98–9.14, P < 0.001) ( Fig. 1 ). CAD is a major cause of SCA in young adults, representing > 50% of SCAs occurring in the fourth decade. With ACS representing the major part of these events, the observed low rates of immediate coronary angiography suggest an important missed opportunity for early intervention.

Hypertension Is an Independent Predictor of Multivessel Coronary Artery Disease in Young Adults with Acute Coronary Syndrome.

Background Risk factors of multivessel coronary artery disease (CAD) among young acute coronary syndrome (ACS) patients remain elusive now. Methods This retrospective study analyzed data from 187 consecutive young (age ≤45 years) ACS patients (75 STEMI, 30 NSTEMI, and 72 unstable angina) hospitalized in our hospital from January 2012 to December 2016. Thirty-six young male patients with normal coronary angiography (CAG) findings (no-CAD), who underwent CAG due to suspected chest pain in this period, served as control group. There were 83 patients with single-vessel disease (SVD) and 104 patients with multiple-vessel disease (MVD) among ACS patients. Patients were followed up for a mean of 267±124 days by clinical visit or telephone calls. Results All included patients were male. Prevalence of hypertension (57.2% vs. 30.6%, p=0.002) and smoking (70.6% vs. 52.8%, p=0.049) was significantly higher in ACS patients than in no-CAD patients. Prevalence of hypertension (72.1% vs. 38.6%, p<0.001) and body mass index (BMI) were significantly higher in MVD group than in SVD group. Multivariable analysis revealed that hypertension was an independent risk factor for MVD after adjustment for age, gender, BMI, smoking, family history of premature CAD, hyperlipidemia, left ventricular ejection fraction, and brain natriuretic peptide (odds ratio=3.71, 95% confidence interval=1.84-7.46, p<0.001). Rate of major adverse cardiovascular events (MACE) during follow-up (20.2% vs. 4.8%) was significantly higher in MVD group compared with SVD group. Conclusions Hypertension is an independent predictor of MVD and MVD is associated with increased MACE rate compared to SVD in young ACS patients during the short-term follow-up.

472Sudden cardiac arrest related to coronary artery disease in young adults

472Sudden cardiac arrest related to coronary artery disease in young adults

The effect of rheumatoid arthritis on the risk of cerebrovascular disease and coronary artery disease in young adults

BackgroundOnly a few studies have investigated the affect of rheumatoid arthritis (RA) on the risk of cerebrovascular disease (CVD)/coronary artery disease (CAD) in young adults. This study, therefore, examined the association between RA and the risk of CVD/CAD in young adults and the interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD. MethodsData regarding 52,840 subjects (10,568 patients with RA and 42,272 age-, sex-, urbanization-, and income-matched non-RA controls) were collected from the National Health Insurance Research Database (NHIRD) in 2006. All subjects were followed until a CVD or CAD diagnosis, or death, or December 31, 2011. The hazard ratios (HRs) of CVD/CAD were estimated using Cox proportional hazard models. The interaction effects between cardiovascular risk factors and RA on the risk of CVD/CAD were assessed using additive and multiplicative models. ResultsRA increased the risk of CVD/CAD in young adults, especially those at risk of ischemic stroke (adjusted HR, 3.48; 95% confidence interval (CI), 2.16–5.61). Even without comorbidity at baseline, patients with RA still had a 2.35-fold greater risk of CVD/CAD relative to those without RA. RA and hypertension interacted positively on the risk of CVD/CAD. The highest CVD/CAD risk was found in patients with RA and hypertension (HR, 9.08; 95% CI, 7.22–11.41) relative to subjects without RA and hypertension. ConclusionRA is an independent risk factor for CVD/CAD in young adults. The government should develop policies for preventing early onset hypertension to reduce the incidence of CVD/CAD among young patients with RA.

P1773Hyperuricemia increases the severity of coronary artery disease in young adults under 35 years old

P1773Hyperuricemia increases the severity of coronary artery disease in young adults under 35 years old

Coronary Artery Disease in Young Adults: Who Needs Surgical Revascularization? A Retrospective Cohort Study.

Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Despite the fact that prevalence accrues with age, an increasing number of young patients suffering from CAD is being observed worldwide. The aim of this study is to describe the population of young adults suffering from CAD and requiring coronary artery bypass grafting (CABG), and to assess early outcomes after the procedure. A retrospective cohort study analyzed 190 consecutive patients aged ≤50 years old that underwent CABG between 2010 and 2014. Baseline characteristics and operative data were presented in the study. Postoperative complications, such as major adverse cardiac and cardiovascular events (MACCE), prolonged mechanical ventilation (&gt;72 hours), bleeding requiring reexploration, sternal dehiscence, and others were assessed. A population comprising mostly overweight or obese males with a mean age of 46 ± 4.1 years was analyzed. Patients suffered mostly from three-vessel disease (81%), hypertension (74.7%), and had previous history of myocardial infarction (MI) (60%). The majority of patients had normal left ventricle ejection fraction (LVEF) (83.1%). 22.6% of cases were emergent procedures. Perioperative mortality was low (1%) and overall MACCE rate stood at 2.6%. Emergent surgery was associated with a higher incidence of postoperative complications (P = .007). The number of diseased vessels, LVEF, and CCS/NYHA class-on-admission was not associated with a higher incidence of postoperative complications (P &gt; .05 for all). CAD in young patients remains an issue described insufficiently in the literature. Among our study cohort of younger patients undergoing CABG, the majority of the patients had multivessel disease and were slightly symptomatic with normal LVEF. Although the postoperative complication rate was low, the percentage of emergent surgeries was alarmingly high in this population. Consistent with the literature, we highlight the importance of CAD screening in the young population to detect subclinical disease, which might be treated therapeutically or operated electively.