Lifeboat Foundation News Blog: Author Genevieve Klien
Premature Coronary Artery Disease: Symptoms, Treatment, And Outlook
Premature coronary artery disease (CAD) is also called "early onset CAD." It means that a younger adult has CAD, though many of the causes and symptoms of CAD are the same at any age.
In the United States, coronary artery disease (CAD) is the most common form of heart disease. It can affect both younger and older individuals, but, when it affects younger individuals, it's classified as premature CAD.
Premature CAD has many of the same symptoms and risks as CAD in older individuals. When signs or symptoms of CAD appear at any age, it's important to take action.
This article will explain more about premature CAD and what steps you can take to reduce the risk of serious health effects, possibly through medication, surgery, or lifestyle changes.
"Premature CAD" means that a younger adult has CAD. Another term for premature CAD is "early onset CAD."
"Coronary artery disease (CAD)" means that there's reduced blood flow in the heart because of a buildup of plaque in the arteries. CAD can be extremely dangerous because plaque buildup can narrow or completely close arteries, causing a heart attack or heart failure.
The symptoms of premature CAD are similar to the symptoms of CAD, and, as mentioned, the first sign many individuals experience is a heart attack.
Symptoms of a heart attack may include:
Even if they don't have a heart attack, many individuals who have premature CAD will experience chest pain or angina. These conditions may occur because the heart isn't getting enough blood, which means that it's also getting reduced levels of oxygen.
Every individual's CAD story is different, but sex may affect the likelihood of experiencing certain symptoms. According to research, females are more likely to experience some of the more atypical symptoms of premature CAD, which may include:
Premature CAD is caused by the buildup of plaque in the coronary arteries. This plaque is made up in part of cholesterol deposits.
Over time, the plaque buildup leads to a narrowing or closing of the arteries, a process called "atherosclerosis." Eventually, CAD can also cause the heart muscle to weaken, which may lead to heart failure.
Risk factors for premature CAD include:
Your ethnicity, sex, and certain genetic conditions may also affect your likelihood of experiencing premature CAD.
There's no cure for premature CAD, but you can do things to reduce their risk of developing CAD. Preventive measures may include:
Medications can also be used to ease the effects of premature CAD on the heart and body. Some medications may be prescribed to lower blood pressure, widen or relax arteries, and decrease the chance of a heart attack, including:
Surgical procedures may be recommended to improve blood flow to and through the heart. These procedures may include coronary bypass surgery or angioplasty and stent placement.
In coronary bypass surgery, a blocked artery is bypassed using another artery or vein in the body.
In an angioplasty and stent placement procedure, an inflated balloon is used to push plaque toward the artery walls and widen the blood vessel. A stent is then placed to help keep the artery open.
Cardiac rehabilitation will likely be necessary if you experience a heart attack or require heart surgery. Rehabilitation may typically include an exercise plan, education on healthy heart practices, and counseling.
Around the world, CAD is the third leading cause of death. It's responsible for 610,000 deaths each year, and 1 in 4 adults younger than 65 years die of CAD, according to 2023 research.
The mortality rate for coronary artery disease (CAD) has decreased over the last 3 decades, but the mortality rate for individuals under 55 years who have CAD has only barely decreased (0.1%) in the last 2 decades.
Additionally, there have been increasing rates of three known risk factors for premature CAD: hypertension, diabetes, and obesity.
More than four-fifths of individuals who have premature CAD also have a risk factor that can be adjusted. These risk factors may include:
Eliminating these risk factors may improve the outlook for people who have premature CAD. This may mean quitting smoking, taking medications to control a health condition, or increasing physical activity.
Premature CAD is a condition in which CAD occurs in males younger than 45 years and females younger than 55 years. It has many of the same symptoms and causes as regular CAD.
If you're showing any symptoms of CAD, such as chest pain, it's important to seek medical assistance regardless of your age. It's also important to make lifestyle decisions that promote heart health at any age.
What Is Diffuse Coronary Artery Disease, And How Is It Treated?
Diffuse coronary artery disease is a subtype of coronary artery disease (CAD) in which larger sections of coronary arteries have a high plaque buildup. It is less common than focal CAD and can be more challenging to treat.
Between 2009 and 2012, CAD affected around 7.6% of men and 5.0% of women in the United States.
This article details the symptoms and risk factors for diffuse CAD, as well as steps a person can take to prevent the condition. It also explores a person's outlook, the complications, diagnosis methods, and treatment options for diffuse CAD.
A 2022 subanalysis suggests that there is no standardized definition of diffuse CAD and that it relies on visual assessment.
However, older research from 2004 defines CAD as one of the following:
The 2022 subanalysis notes that there is also a newer metric to define CAD patterns called the pullback pressure gradient (PPG).
The PPG identifies the focal or diffuse pattern of CAD based on the location and extent of the drops in blood flow pressure along the coronary artery.
This metric provides the pattern of CAD with a numerical value. A value of 0 indicates diffuse CAD, and a value of 1 indicates focal CAD.
Symptoms of diffuse CAD are similar to those of focal CAD. According to a 2023 overview of research, these include:
Some of these symptoms could indicate that diffuse CAD has developed into a life threatening condition, such as heart failure or heart attack.
Anyone with symptoms of a heart attack should seek immediate medical attention. Symptoms include:
Diffuse CAD arises when there is a buildup of plaque in the arteries supplying blood to the heart. A paper from 2015 suggests that diffuse CAD can affect those with:
Other factors that can increase the risk of developing CAD include:
Researchers continue to study other CAD risk factors. Some possible risk factors include nonalcoholic fatty liver disease and rheumatoid arthritis.
Doctors diagnose diffuse CAD using the following tests:
Surgery is an important part of focal CAD treatment. However, the significant buildups of plaque in those with diffuse CAD can make surgery more challenging.
Despite these challenges, a 2019 study notes that the average person with diffuse CAD could benefit from surgery. A 2017 study found similar results.
A surgeon may perform coronary bypass surgery. During this procedure, a surgeon uses healthy blood vessels from another part of the body, such as the leg or chest, and connects them to the blood vessels near the blocked artery. This creates a new route for the blood to flow through.
For those who are unable to undergo surgery, an interventional cardiologist may perform a stent placement. To do this, the healthcare professional will thread a thin tube with an empty balloon attached to the end through a blood vessel.
They will then place the balloon in the blocked artery and inflate it, allowing them to open the stent and place it into position.
Medications can include:
It may not be possible to prevent diffuse CAD with complete certainty. However, taking some steps could reduce the risk of developing this condition.
As the 2023 paper makes clear, some risk factors, such as diet and a lack of exercise, are modifiable. A person may benefit from maintaining a healthy lifestyle, which includes:
CAD is a serious condition and is the most common cause of death in the United States.
According to a 2018 paper, research suggests that people with diffuse CAD have a lower survival rate than people with focal CAD.
However, the survival rate for diffuse CAD varies from person to person. Demographic factors, overall health, and other health conditions can all affect an individual's outlook.
It is important to contact a doctor as soon as possible if a person experiences any symptoms of CAD.
There are many possible complications of diffuse CAD. According to the 2023 review, some common complications of CAD include:
CAD refers to a buildup of plaque in the coronary arteries, which supply blood to the heart. Diffuse CAD is when large sections of the coronary artery have this plaque buildup.
Diffuse CAD can sometimes make treating the condition with surgery or stenting more challenging. It also increases the risk of death from CAD complications, including heart failure and heart attack.
However, a surgeon can treat the condition by performing a coronary bypass. For those unable to have surgery, an interventional cardiologist can insert a stent. A healthcare professional may also prescribe medications such as beta-blockers and ACE inhibitors.
People can take steps to prevent or manage diffuse CAD. These include exercising regularly, not smoking, and eating a heart-healthy diet.
Coronary Artery Disease Discovery Offers Answers About Nation's No. 1 Killer
University of Virginia Health researchers probing the causes of coronary artery disease have identified critical biological processes that can go wrong inside the linings of blood vessels and contribute to the dangerous plaque buildup responsible for the disease.
The discovery provides new targets for scientists looking for better ways to treat and prevent the disease. The researchers published their findings in the scientific journal Circulation: Genomic and Precision Medicine.
Coronary artery disease is the nation's No. 1 killer and responsible for 25% of deaths in the United States. More than 600,000 Americans die from the disease every year and more than 17 million die from it worldwide.
"Smooth muscle cells that make up the bulk of our blood vessels play important roles in coronary artery disease. They undergo pathological transformations as the disease develops inside our arteries," said researcher Mete Civelek, of the University of Virginia School of Medicine's Center for Public Health Genomics and the Department of Biomedical Engineering.
"Our results point to a previously underappreciated role for metabolic pathways during this pathological transformation," he said.
Civelek and his team wanted to unravel a longstanding mystery about the behavior of smooth muscle cells during plaque formation. These cells, which line blood vessels, protect the body during plaque formation by building stabilizing caps over the plaque that prevent the lesions from breaking loose and causing strokes.
But sometimes smooth muscle cells begin to accelerate the plaque development and spur the progression of the disease, scientists believe.
Civelek's new discovery helps explain why. Noah Perry, a doctoral student on Civelek's team, analyzed smooth muscle cells collected from 151 heart transplant donors and used a sophisticated approach to identify genes responsible for the smooth muscle cells' behavior.
After initially identifying 86 groups of genes, the researchers focused in on 18 groups that could explain the mysterious behavior. Their analysis suggested that the smooth muscle cells' shift to the dark side of health might stem from problems with how the cells use nitrogen and glycogen. Glycogen is how the body stores the sugar glucose.
The researchers identified a particular sugar, mannose, that may be contributing to the problems, potentially even triggering them. But determining that, the scientists say, will require more research.
"The metabolic shift in the cells as they transition to a disease state can point to points of intervention and therapy," said Perry, of UVA's Department of Biomedical Engineering, the lead author of the study.
By better understanding what triggers the smooth muscle cells to become harmful, Civelek says, doctors may be able to develop ways to prevent that from happening. That could open the door to new ways to treat and prevent coronary artery disease.
"Coronary artery disease is still the leading cause of death worldwide," Civelek said. "Although cholesterol-lowering therapies and blood pressure control have been very effective tools to prevent deaths from heart attacks, we still need more targets to reduce the suffering of patients and their families from this devastating disease."
The research team consisted of Perry, Diana Albarracin, Redouane Aherrahrou and Civelek.
More information: R. Noah Perry et al, Network Preservation Analysis Reveals Dysregulated Metabolic Pathways in Human Vascular Smooth Muscle Cell Phenotypic Switching, Circulation: Genomic and Precision Medicine (2023). DOI: 10.1161/CIRCGEN.122.003781
Citation: Coronary artery disease discovery offers answers about nation's no. 1 killer (2023, August 14) retrieved 27 August 2023 from https://medicalxpress.Com/news/2023-08-coronary-artery-disease-discovery-nation.Html
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