Contemporary outcomes studies to identify and mitigate the risk in patients with premature cardiovascular disease

Introduction: As the leading cause of death globally, atherosclerotic cardiovascular disease (ASCVD) carries substantial cost burden for patients and the healthcare system. Although overall mortality rates have recently decreased in certain groups, such improvements were not observed in younger ASCVD patients. This review focuses on premature ASCVD and explores risk factors affecting this younger cohort of patients. Areas covered: We performed a literature search for studies assessing premature ASCVD, defined as ischemic heart disease (IHD), ischemic cerebrovascular disease (ICVD), or peripheral arterial disease (PAD) occurring in men aged ≤55 years and women aged ≤65 years. Expert opinion: Premature ASCVD patients often suffer from multiple traditional cardiovascular risk factors, in addition to genetic predisposition or unique non-traditional features, such as substance abuse and chronic inflammatory conditions. Consequently, identification and management of at-risk individuals pose a great challenge for clinicians. In this younger patient cohort, control of traditional risk factors, optimization of primary and secondary prevention therapies, and lifestyle modifications are imperative to saving potential disability-adjusted life years and other costs associated with premature atherosclerosis.