What Causes Premature Coronary Artery Disease?

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE Current Atherosclerosis Reports Pub Date : 2024-04-04 DOI:10.1007/s11883-024-01200-y

Ann Le, Helen Peng, Danielle Golinsky, Matteo Di Scipio, Ricky Lali, Guillaume Paré

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Abstract

Purpose of Review

This review provides an overview of genetic and non-genetic causes of premature coronary artery disease (pCAD).

Recent Findings

pCAD refers to coronary artery disease (CAD) occurring before the age of 65 years in women and 55 years in men. Both genetic and non-genetic risk factors may contribute to the onset of pCAD. Recent advances in the genetic epidemiology of pCAD have revealed the importance of both monogenic and polygenic contributions to pCAD. Familial hypercholesterolemia (FH) is the most common monogenic disorder associated with atherosclerotic pCAD. However, clinical overreliance on monogenic genes can result in overlooked genetic causes of pCAD, especially polygenic contributions. Non-genetic factors, notably smoking and drug use, are also important contributors to pCAD. Cigarette smoking has been observed in 25.5% of pCAD patients relative to 12.2% of non-pCAD patients. Finally, myocardial infarction (MI) associated with spontaneous coronary artery dissection (SCAD) may result in similar clinical presentations as atherosclerotic pCAD.

Summary

Recognizing the genetic and non-genetic causes underlying pCAD is important for appropriate prevention and treatment. Despite recent progress, pCAD remains incompletely understood, highlighting the need for both awareness and research.

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什么原因导致冠心病早发？

综述目的本综述概述了早发性冠状动脉疾病（pCAD）的遗传和非遗传原因。最新研究结果pCAD 是指女性在 65 岁之前、男性在 55 岁之前发生的冠状动脉疾病（CAD）。遗传和非遗传风险因素都可能导致早发性冠状动脉疾病的发生。最近在 pCAD 遗传流行病学方面取得的进展揭示了单基因和多基因对 pCAD 的重要作用。家族性高胆固醇血症（FH）是与动脉粥样硬化性 pCAD 相关的最常见的单基因疾病。然而，临床上对单基因的过度依赖可能会导致 pCAD 的遗传原因被忽视，尤其是多基因因素。非遗传因素，尤其是吸烟和吸毒，也是导致 pCAD 的重要因素。据观察，25.5% 的 pCAD 患者吸烟，而非 pCAD 患者吸烟的比例仅为 12.2%。最后，与自发性冠状动脉夹层（SCAD）相关的心肌梗死（MI）可能会导致与动脉粥样硬化性 pCAD 相似的临床表现。尽管最近取得了一些进展，但人们对 pCAD 的了解仍不全面，这凸显了提高认识和开展研究的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.

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