Multiple Modifiable Risk Factors in Young Adults with Heart Attack Interview with:

Srikanth Yandrapalli, MD Chief Resident in Internal Medicine at New York Medical College at  Westchester Medical Center Program 

Dr. Yandrapalli

Srikanth Yandrapalli, MD
Chief Resident in Internal Medicine at New York Medical College at
Westchester Medical Center Program What is the background for this study? What are the main findings?

Response: Risk factors play an important role in the development of and progression of coronary heart disease, thus necessitating strategies to address the leading modifiable risk factors to reduce the burden of coronary heart disease. Data are lacking regarding therecent temporal trends in the prevalence of these risk factors during a first AMI in US young adults.

In our study, we report that among young adults in the US with a first acute myocardial infarction, the prevalence rates of major modifiable risk factors were very high with over 90% of patients having at least 1 such risk factor. Significant sex and racial disparities were observed. Sex differences in the rates of certain  risk factors were clearly evident with males having higher rates of smoking, dyslipidemia, and drug abuse, whereas females had higher rates metabolic risk factors like diabetes mellitus, hypertension, and obesity. Sex differences in the rates of certain risk factors narrowed with increasing age and over time. Blacks had higher rates of hypertension, obesity, and drug abuse, Whites had higher rates of smoking, Hispanics had higher rates of diabetes mellitus and patients of Asian/Pacific Islander race had higher rates of dyslipidemia. Prevalence rates progressively increased between 2005 and 2015 except for dyslipidemia for which a decreasing trend was noted more recently. What should readers take away from your report?

 Response: During a first acute myocardial infarction episode in young adults in whom preventive measures are more likely to be effective, modifiable cardiac risk factors were highly prevalent and their rates progressively increased over time. Significant sex and racial disparities were observed for individual risk factors. Improved primordial, primary, and secondary preventative strategies are needed in this susceptible population to reduce the burden of coronary heart disease in the United States. Risk prevention strategies should utilize a tailored approach to appropriately target vulnerable populations. What recommendations do you have for future research as a result of this work?

Response: Further studies and emerging data should facilitate the understanding of the pathophysiologic and socio-demographic differences responsible sex and race disparities in the prevalence of individual risk factors, and such data can be utilized to improve overall cardiovascular outcomes.

No relevant disclosures. 


Modifiable Risk Factors in Young Adults With First Myocardial Infarction 
Yandrapalli S, Nabors C, Goyal A, Aronow WS, Frishman WH.
J Am Coll Cardiol 2019;73:573-584.


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