In the Journals

Traditional risk factors fail to entirely explain atherosclerosis

Among those who died young from noncardiac causes, 13% exhibited atherosclerosis beyond the traditional risk factors for CHD, according to a report published in the American Heart Journal.

The study consisted of 2,651 participants aged 15 to 34 years from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) cohort who had died of noncardiac deaths such as suicides, homicides or automobile accidents. Tissues and other samples were harvested for analysis.

“Factors influencing the incidence of [sudden cardiac death] are exceptionally diverse, extend way beyond simple atherosclerotic plaque burden and involve processes related to thrombotic diathesis, rhythm disorders and other complex systems,” Trajen Head, PhD, from the department of biochemistry and molecular biology at the University of Miami Miller School of Medicine, and colleagues wrote.

Participants were segregated into two groups: 739 individuals possessing complete observations for all measured risk factors except for serum concentrations of C-reactive protein, and the remaining 1,912 participants. The PDAY research varied from studies such as ARIC and PROSPECT, which enrolled adults aged 50 to 65 years who already exhibited acute coronary events.

The researchers analyzed the right coronary artery for the presence of raised lesions as a key marker for CHD. Researchers used two different analyses — a de facto analysis that stratified the population age by observing the number of coronary lesions and examining the groups through Poisson regression modeling; and a de novo approach using Poisson mixture modeling to generate low- and high-growth groups based on measurements of traditional risk factors.

Through the Poisson mixture model, 234 individuals were identified belonging to the high-growth group, with another 164 individuals sometimes included in the high-growth group and sometimes included in the low-growth group in the de novo segregation. The de facto group identified 76% individuals who were consistently included in the de novo high-growth group. In the model, individuals in the high-growth group by age 25 years exhibited, on average, a 22-fold increase in lesion formation in the right coronary artery compared with the remaining population. Head and colleagues wrote that none of studied traditional risk factors, except for age, contributed to number of raised lesions in the high-growth group.

The researchers wrote the study emphasized the importance of continuing to seek out additional potential CHD risk factors and predictors.

“Identification of these individuals at risk early could have tremendous effect on disease prevention and on avoiding deadly outcomes, through more efficient disease management and treatment,” they wrote. – by Earl Holland

Disclosures: The authors report no relevant financial disclosures.

Among those who died young from noncardiac causes, 13% exhibited atherosclerosis beyond the traditional risk factors for CHD, according to a report published in the American Heart Journal.

The study consisted of 2,651 participants aged 15 to 34 years from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) cohort who had died of noncardiac deaths such as suicides, homicides or automobile accidents. Tissues and other samples were harvested for analysis.

“Factors influencing the incidence of [sudden cardiac death] are exceptionally diverse, extend way beyond simple atherosclerotic plaque burden and involve processes related to thrombotic diathesis, rhythm disorders and other complex systems,” Trajen Head, PhD, from the department of biochemistry and molecular biology at the University of Miami Miller School of Medicine, and colleagues wrote.

Participants were segregated into two groups: 739 individuals possessing complete observations for all measured risk factors except for serum concentrations of C-reactive protein, and the remaining 1,912 participants. The PDAY research varied from studies such as ARIC and PROSPECT, which enrolled adults aged 50 to 65 years who already exhibited acute coronary events.

The researchers analyzed the right coronary artery for the presence of raised lesions as a key marker for CHD. Researchers used two different analyses — a de facto analysis that stratified the population age by observing the number of coronary lesions and examining the groups through Poisson regression modeling; and a de novo approach using Poisson mixture modeling to generate low- and high-growth groups based on measurements of traditional risk factors.

Through the Poisson mixture model, 234 individuals were identified belonging to the high-growth group, with another 164 individuals sometimes included in the high-growth group and sometimes included in the low-growth group in the de novo segregation. The de facto group identified 76% individuals who were consistently included in the de novo high-growth group. In the model, individuals in the high-growth group by age 25 years exhibited, on average, a 22-fold increase in lesion formation in the right coronary artery compared with the remaining population. Head and colleagues wrote that none of studied traditional risk factors, except for age, contributed to number of raised lesions in the high-growth group.

The researchers wrote the study emphasized the importance of continuing to seek out additional potential CHD risk factors and predictors.

“Identification of these individuals at risk early could have tremendous effect on disease prevention and on avoiding deadly outcomes, through more efficient disease management and treatment,” they wrote. – by Earl Holland

Disclosures: The authors report no relevant financial disclosures.