Key result
Dyspnea and abnormal myocardial perfusion imaging were significant risk factors for major adverse cardiac events across all age groups, while diabetes and smoking were significant from age 59 onwards.
Why the study?
Although traditional cardiovascular risk factor prevalence shows age-specific patterns, it was not known whether the prognostic impact of these risk factors is similarly age-specific.
Does the prognostic impact of traditional cardiovascular risk factors and MPI outcomes on major adverse cardiac events vary by age in patients with suspected or known CAD?
Cohort (n=3,667)
Does the prognostic impact of traditional cardiovascular risk factors and MPI outcomes on major adverse cardiac events vary by age in patients with suspected or known CAD?
The prognostic value of traditional cardiovascular risk factors for MACE varies significantly by age, though abnormal MPI and dyspnea remain universally predictive.
BACKGROUND: The prevalence of traditional cardiovascular risk factors shows different age-specific patterns. It is not known whether the prognostic impact of risk factors is similarly age-specific. We evaluated the profiles of cardiovascular risk factors and their prognostic impact on coronary artery disease (CAD) in relation to age. METHODS: We included 3667 patients with suspected or known CAD undergoing stress myocardial perfusion imaging (MPI). We evaluated the risk for major adverse cardiac events (MACE) within three years from the index MPI in patients belonging to three groups according to age tertile distribution: <59, 59-68, and >68 years. Gender, body mass index, diabetes, hypertension, dyslipidemia, family history of CAD, smoking, angina, dyspnea, previous CAD, and MPI outcome were assessed as risk factors by a multivariable Cox's regression. Dyspnea and abnormal MPI outcome were significant risk factors for all age groups. Diabetes and smoking were significant from the age of 59 onwards, while hypertension resulted significant for patients older than 68 years. CONCLUSIONS: The number of risk factors was significantly associated with the occurrence of MACE increase with age. It is noteworthy that a personal history of CAD was not useful for risk stratification, while MPI results were.
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Megna et al. (2023) conducted a cohort in Suspected or known coronary artery disease (n=3,667). Cardiovascular risk factors was evaluated on Major adverse cardiac events (MACE) within three years. Dyspnea and abnormal myocardial perfusion imaging were significant risk factors for major adverse cardiac events across all age groups, while diabetes and smoking were significant from age 59 onwards.
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