Differences in Clinical Profiles and Outcomes Between Early-onset and Older Patients Hospitalized for Coronary Artery Disease: A Prospective Cohort Study.

Abstract Background Contemporary data on age-dependent differences in risk factors, hospital care and outcomes between early-onset and older patients with coronary artery disease (CAD) is limited in Han Chinese. Methods In this nation-wide, prospective cohort study, a total of 1524 early-onset patients (onset age ≤ 45 years) and 1374 older patients (onset age ≥ 65 years) with angiographically established severe atherosclerotic obstructive CAD were included from 38 hospitals across China. Participants were followed three years for major adverse cardiovascular events (MACE). Results Compared to older patients, male sex (95.6%), smoking (74.8%), drinking (43.6%), and obesity (30.1%) were more prevalent, whereas hypertension and diabetes were less common among young patients (all P < 0.001). Early-onset patients were more likely to present with ST-segment elevation myocardial infarction (MI), and to undergo revascularization, but be treated with suboptimal guideline-directed medications than their older counterparts (all P < 0.001). During the follow-up, 96 (6.3%) early-onset patients developed MACE. Female sex (adjusted hazard ratio [HR] = 2.40; 95% confidence interval [CI]: 1.07–5.38), previous MI (adjusted HR = 2.23; 95%CI:1.44–3.45), and the number of diseased vessels (adjusted HR = 1.93; 95%CI:1.12–3.34) were strong baseline determinants of subsequent MACE. Early-onset patients were at a greater risk of non-target lesion acceleration than the older patients (adjusted HR = 2.39; 95%CI:1.83–3.09). Conclusion Early-onset CAD patients in China carried a heavier burden of modifiable risk factors pertaining to unhealthy behaviors and had a higher risk of aggressive progression of non-target lesions than older patients. Intensive secondary prophylactic measures are recommended among young adults against future ischemic events. Trial registration: www.clinicaltrials.gov (NCT 02496858).

Medienart:	Preprint

Erscheinungsjahr:	2024
Erschienen:	2024

Enthalten in:	ResearchSquare.com - (2024) vom: 05. Apr. Zur Gesamtaufnahme - year:2024

Sprache:	Englisch

Beteiligte Personen:	Shali, Shalaimaiti [VerfasserIn] Yao, Kang [VerfasserIn] Luo, Linfeng [VerfasserIn] Wu, Hongyi [VerfasserIn] Zhang, Shuning [VerfasserIn] Xu, Lili [VerfasserIn] Gao, Wei [VerfasserIn] Li, Jianxuan [VerfasserIn] Xu, Rende [VerfasserIn] Chang, Shufu [VerfasserIn] Li, Chenguang [VerfasserIn] Qian, Juying [VerfasserIn] Zheng, Yan [VerfasserIn] Dai, Yuxiang [VerfasserIn] Ge, Junbo [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	570 Biology

doi:	10.21203/rs.3.rs-4204264/v1

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	XRA043178634