Gender Differences in Premature Coronary Artery Disease (from the National Data from the NHANES Database)

Coronary artery disease (CAD) has traditionally been seen as a disease of older individuals, however, CAD affects a significant proportion of young adult women and men. Premature CAD is becoming an area of increased interest, and is defined as CAD occurring in women <65 years and men <55 years of age. 1 Arnett DK Blumenthal RS Albert MA Buroker AB Goldberger ZD Hahn EJ Himmelfarb CD Khera A Lloyd-Jones D McEvoy JW Michos ED Miedema MD Muñoz D Smith SC Virani SS Williams KA Yeboah J Ziaeian B. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 140: e596-e646 PubMed Google Scholar Overall, the rate of cardiovascular disease mortality has significantly declined over the past 4 decades; however, this decline not been observed as proportionately in young adult women and men. 2 Gupta A Wang Y Spertus JA Geda M Lorenze N Nkonde-Price C D'Onofrio G Lichtman JH Krumholz H Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J Am Coll Cardiol. 2014; 64: 337-345 Crossref PubMed Scopus (245) Google Scholar Indeed, recent data suggests that the incidence of premature CAD has not declined in recent years and cardiovascular risk factors seem to be increasing in this population. 3 Vikulova DN Grubisic M Zhao Y Lynch K Humphries KH Pimstone SN Brunham LR. Premature atherosclerotic cardiovascular disease: trends in incidence, risk factors, and sex-related differences, 2000 to 2016. J Am Heart Assoc. 2019; 8e012178 Crossref PubMed Scopus (24) Google Scholar To date, most studies addressing CAD have included a predominantly older male population, thus making it difficult to identify the unique presentations and risk factors associated with young adults. This important research gap warrants further investigation as some evidence supports important gender differences in baseline risk factors, comorbidities, dietary habits and lifestyle variables in patients with premature CAD. In these analyses, we investigate important demographic differences between young adult men and women with premature CAD from a large national database.