Cardiovascular Risk and Statin Eligibility of Young Adults After an MI: Partners YOUNG-MI Registry

Avinainder Singh, Bradley L. Collins, Ankur Gupta, Amber Fatima, Arman Qamar, David Biery, Julio Baez, Mary Cawley, Josh Klein, Jon Hainer, Jorge Plutzky, Christopher P. Cannon, Khurram Nasir, Marcelo F. Di Carli, Deepak L. Bhatt, Ron Blankstein

Research output: Contribution to journalArticle

58 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)292-302
Number of pages11
JournalJournal of the American College of Cardiology
Volume71
Issue number3
DOIs
StatePublished - Jan 23 2018

Keywords

  • myocardial infarction
  • prevention
  • risk
  • statin
  • young adults

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Cardiovascular Risk and Statin Eligibility of Young Adults After an MI: Partners YOUNG-MI Registry'. Together they form a unique fingerprint.

Cite this