Avinainder Singh1, Bradley L Collins1, Ankur Gupta1, Amber Fatima2, Arman Qamar3, David Biery1, Julio Baez1, Mary Cawley1, Josh Klein1, Jon Hainer1, Jorge Plutzky3, Christopher P Cannon3, Khurram Nasir4, Marcelo F Di Carli1, Deepak L Bhatt3, Ron Blankstein5. 1. Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Medicine, Tufts Medical Center, Boston, Massachusetts. 3. Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 4. Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida. 5. Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: rblankstein@bwh.harvard.edu.
Abstract
BACKGROUND: Despite significant progress in primary prevention, the rate of MI has not declined in young adults. OBJECTIVES: The purpose of this study was to evaluate statin eligibility based on the 2013 American College of Cardiology/American Heart Association guidelines for treatment of blood cholesterol and 2016 U.S. Preventive Services Task Force recommendations for statin use in primary prevention in a cohort of adults who experienced a first-time myocardial infarction (MI) at a young age. METHODS: The YOUNG-MI registry is a retrospective cohort from 2 large academic centers, which includes patients who experienced an MI at age ≤50 years. Diagnosis of type 1 MI was adjudicated by study physicians. Pooled cohort risk equations were used to estimate atherosclerotic cardiovascular disease risk score based on data available prior to MI or at the time of presentation. RESULTS: Of 1,685 patients meeting inclusion criteria, 210 (12.5%) were on statin therapy prior to MI and were excluded. Among the remaining 1,475 individuals, the median age was 45 years, there were 294 (20%) women, and 846 (57%) had ST-segment elevation MI. At least 1 cardiovascular risk factor was present in 1,225 (83%) patients. The median 10-year atherosclerotic cardiovascular disease risk score of the cohort was 4.8% (interquartile range: 2.8% to 8.0%). Only 724 (49%) and 430 (29%) would have met criteria for statin eligibility per the 2013 American College of Cardiology/American Heart Association guidelines and 2016 U.S. Preventive Services Task Force recommendations, respectively. This finding was even more pronounced in women, in whom 184 (63%) were not eligible for statins by either guideline, compared with 549 (46%) men (p < 0.001). CONCLUSIONS: The vast majority of adults who present with an MI at a young age would not have met current guideline-based treatment thresholds for statin therapy prior to their MI. These findings highlight the need for better risk assessment tools among young adults.
BACKGROUND: Despite significant progress in primary prevention, the rate of MI has not declined in young adults. OBJECTIVES: The purpose of this study was to evaluate statin eligibility based on the 2013 American College of Cardiology/American Heart Association guidelines for treatment of blood cholesterol and 2016 U.S. Preventive Services Task Force recommendations for statin use in primary prevention in a cohort of adults who experienced a first-time myocardial infarction (MI) at a young age. METHODS: The YOUNG-MI registry is a retrospective cohort from 2 large academic centers, which includes patients who experienced an MI at age ≤50 years. Diagnosis of type 1 MI was adjudicated by study physicians. Pooled cohort risk equations were used to estimate atherosclerotic cardiovascular disease risk score based on data available prior to MI or at the time of presentation. RESULTS: Of 1,685 patients meeting inclusion criteria, 210 (12.5%) were on statin therapy prior to MI and were excluded. Among the remaining 1,475 individuals, the median age was 45 years, there were 294 (20%) women, and 846 (57%) had ST-segment elevation MI. At least 1 cardiovascular risk factor was present in 1,225 (83%) patients. The median 10-year atherosclerotic cardiovascular disease risk score of the cohort was 4.8% (interquartile range: 2.8% to 8.0%). Only 724 (49%) and 430 (29%) would have met criteria for statin eligibility per the 2013 American College of Cardiology/American Heart Association guidelines and 2016 U.S. Preventive Services Task Force recommendations, respectively. This finding was even more pronounced in women, in whom 184 (63%) were not eligible for statins by either guideline, compared with 549 (46%) men (p < 0.001). CONCLUSIONS: The vast majority of adults who present with an MI at a young age would not have met current guideline-based treatment thresholds for statin therapy prior to their MI. These findings highlight the need for better risk assessment tools among young adults.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Maarten L Simoons; Bernard R Chaitman; Harvey D White; Kristian Thygesen; Joseph S Alpert; Harvey D White; Allan S Jaffe; Hugo A Katus; Fred S Apple; Bertil Lindahl; David A Morrow; Bernard R Chaitman; Peter M Clemmensen; Per Johanson; Hanoch Hod; Richard Underwood; Jeroen J Bax; Jeroen J Bonow; Fausto Pinto; Raymond J Gibbons; Keith A Fox; Dan Atar; L Kristin Newby; Marcello Galvani; Christian W Hamm; Barry F Uretsky; Ph Gabriel Steg; William Wijns; Jean-Pierre Bassand; Phillippe Menasche; Jan Ravkilde; E Magnus Ohman; Elliott M Antman; Lars C Wallentin; Paul W Armstrong; Maarten L Simoons; James L Januzzi; Markku S Nieminen; Mihai Gheorghiade; Gerasimos Filippatos; Russell V Luepker; Stephen P Fortmann; Wayne D Rosamond; Dan Levy; David Wood; Sidney C Smith; Dayi Hu; Jose-Luis Lopez-Sendon; Rose Marie Robertson; Douglas Weaver; Michal Tendera; Alfred A Bove; Alexander N Parkhomenko; Elena J Vasilieva; Shanti Mendis; Jeroen J Bax; Helmut Baumgartner; Claudio Ceconi; Veronica Dean; Christi Deaton; Robert Fagard; Christian Funck-Brentano; David Hasdai; Arno Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Theresa McDonagh; Cyril Moulin; Bogdan A Popescu; Zeljko Reiner; Udo Sechtem; Per Anton Sirnes; Michal Tendera; Adam Torbicki; Alec Vahanian; Stephan Windecker; Joao Morais; Carlos Aguiar; Wael Almahmeed; David O Arnar; Fabio Barili; Kenneth D Bloch; Ann F Bolger; Hans Erik Botker; Biykem Bozkurt; Raffaele Bugiardini; Christopher Cannon; James de Lemos; Franz R Eberli; Edgardo Escobar; Mark Hlatky; Stefan James; Karl B Kern; David J Moliterno; Christian Mueller; Aleksandar N Neskovic; Burkert Mathias Pieske; Steven P Schulman; Robert F Storey; Kathryn A Taubert; Pascal Vranckx; Daniel R Wagner Journal: J Am Coll Cardiol Date: 2012-09-05 Impact factor: 24.094
Authors: Michael D Miedema; Faye L Lopez; Michael J Blaha; Salim S Virani; Josef Coresh; Christie M Ballantyne; Aaron R Folsom Journal: JAMA Intern Med Date: 2015-01 Impact factor: 21.873
Authors: Ann Marie Navar-Boggan; Eric D Peterson; Ralph B D'Agostino; Michael J Pencina; Allan D Sniderman Journal: J Am Coll Cardiol Date: 2015-03-02 Impact factor: 24.094
Authors: Andrew Paul DeFilippis; Rebekah Young; John W McEvoy; Erin D Michos; Veit Sandfort; Richard A Kronmal; Robyn L McClelland; Michael J Blaha Journal: Eur Heart J Date: 2017-02-21 Impact factor: 29.983
Authors: Liam R Brunham; Kelsey Lynch; Amy English; Rory Sutherland; Jian Weng; Raymond Cho; Graham C Wong; Aslam H Anis; Gordon A Francis; Nadia A Khan; Bruce McManus; David Wood; Keith R Walley; Jonathon Leipsic; Karin H Humphries; Alison Hoens; Andrew D Krahn; G B John Mancini; Simon Pimstone Journal: Clin Cardiol Date: 2018-06-11 Impact factor: 2.882
Authors: Cara Lea Smith; Matthew Seigerman; Srinath Adusumalli; Jay Giri; Paul N Fiorilli; Daniel M Kolansky; Taisei Kobayashi Journal: Curr Cardiol Rep Date: 2021-03-08 Impact factor: 2.931
Authors: Michael S Garshick; Georgeta D Vaidean; Anish Vani; James A Underberg; Jonathan D Newman; Jeffrey S Berger; Edward A Fisher; Eugenia Gianos Journal: Cardiology Date: 2019-05-10 Impact factor: 1.869
Authors: Ersilia M DeFilippis; Bradley L Collins; Avinainder Singh; David W Biery; Amber Fatima; Arman Qamar; Adam N Berman; Ankur Gupta; Mary Cawley; Malissa J Wood; Josh Klein; Jon Hainer; Martha Gulati; Viviany R Taqueti; Marcelo F Di Carli; Khurram Nasir; Deepak L Bhatt; Ron Blankstein Journal: Eur Heart J Date: 2020-11-07 Impact factor: 29.983
Authors: Junjie Yang; David W Biery; Avinainder Singh; Sanjay Divakaran; Ersilia M DeFilippis; Wanda Y Wu; Josh Klein; Jon Hainer; Mattheus Ramsis; Pradeep Natarajan; James L Januzzi; Khurram Nasir; Deepak L Bhatt; Marcelo F Di Carli; Ron Blankstein Journal: Am J Med Date: 2019-11-09 Impact factor: 4.965
Authors: Donna K Arnett; Roger S Blumenthal; Michelle A Albert; Andrew B Buroker; Zachary D Goldberger; Ellen J Hahn; Cheryl Dennison Himmelfarb; Amit Khera; Donald Lloyd-Jones; J William McEvoy; Erin D Michos; Michael D Miedema; Daniel Muñoz; Sidney C Smith; Salim S Virani; Kim A Williams; Joseph Yeboah; Boback Ziaeian Journal: J Am Coll Cardiol Date: 2019-03-17 Impact factor: 24.094
Authors: Donna K Arnett; Roger S Blumenthal; Michelle A Albert; Andrew B Buroker; Zachary D Goldberger; Ellen J Hahn; Cheryl Dennison Himmelfarb; Amit Khera; Donald Lloyd-Jones; J William McEvoy; Erin D Michos; Michael D Miedema; Daniel Muñoz; Sidney C Smith; Salim S Virani; Kim A Williams; Joseph Yeboah; Boback Ziaeian Journal: Circulation Date: 2019-03-17 Impact factor: 29.690