Fast Five Quiz: Coronary Artery Atherosclerosis

Yasmine S. Ali, MD

Disclosures

November 11, 2019

Many traditional risk factors for CAD are related to lifestyle, and preventive treatment can be tailored to modifying specific factors. The risk of developing CAD increases with age and includes age older than 45 years in men and older than 55 years in women. A family history of early heart disease is also a risk factor, including heart disease in the father or a brother diagnosed before age 55 years and in the mother or a sister diagnosed before age 65 years.

Risk factors for the development and progression of atherosclerosis include the following:

  • Hyperlipidemia and dyslipidemia

  • Hypertension

  • Cigarette habituation

  • Air pollution

  • Diabetes mellitus

  • Age

  • Sex

Other risk factors for coronary artery atherosclerosis include the following:

  • Family history of premature CAD

  • Hypoalphalipoproteinemia

  • Obesity

  • Physical inactivity

  • Syndromes of accelerated atherosclerosis: graft atherosclerosis, CAD after cardiac transplantation

  • Chronic kidney disease

  • Systemic lupus erythematosus

  • Rheumatoid arthritis

  • Metabolic syndrome

  • Chronic inflammation

  • Infectious agents

  • Increased fibrinogen levels

  • Increased lipoprotein(a) levels

  • Familial hypercholesterolemia

  • Depression

  • Sleep disorders

According to the American Heart Association (AHA) guideline on CVD prevention in women, risk factors that are more common or may be more significant in women include psychosocial factors, such as depression, and autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

Guidelines from the American College of Cardiology (ACC)/AHA do not recommend the following measures for coronary heart disease risk assessment in asymptomatic adults:

  • Measurement of lipid parameters beyond a standard lipid profile (A standard lipid profile is recommended as part of global risk scoring.)

  • Brachial/peripheral arterial flow-mediated dilation studies

  • Specific measures of arterial stiffness

  • Coronary CT angiography

  • MRI for detection of vascular plaque

Read more about the risk factors for CAD.

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