What Causes Premature Coronary Artery Disease?
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or primary data synthesis.
PubMed 38573470 · doi:10.1007/s11883-024-01200-y
What was done
This narrative review summarizes genetic and non-genetic causes of premature coronary artery disease (pCAD), defined as coronary artery disease manifesting before age 65 in women and age 55 in men.
What was found
Familial hypercholesterolemia was identified as the most common monogenic cause of atherosclerotic pCAD, though polygenic architecture also plays a major role. Among non-genetic risk factors, cigarette smoking was reported in 25.5% of pCAD patients compared to 12.2% of non-pCAD patients. Drug use and non-atherosclerotic conditions such as spontaneous coronary artery dissection (SCAD) were also highlighted as important contributors or clinical mimics.
Why it matters
Early-onset coronary disease requires evaluation beyond classic monogenic screening, emphasizing polygenic risk profiling and modifiable lifestyle factors such as smoking.
Limits
The abstract describes a narrative review without systematic search criteria, meta-analytic pooling, or formal risk-of-bias assessment. Specific effect sizes, population demographics, and study sizes for cited statistics are not detailed in the abstract.
Cited by
- supports Excessively high cholesterol is associated with earlier heart disease, heart attacks, and strokes.