Monitoring of traditional atherosclerosis cardiovascular disease risk factors - is it enough to prevent premature acute coronary syndrome?

Atherosclerotic cardiovascular disease is the leading cause of death worldwide, and the high prevalence of risk factors makes the occurrence of premature acute coronary syndrome a significant healthcare problem.1 The prevalence of acute coronary syndrome <60 years of age is 3.8% and is three-fold greater above 60. 1 in 4 new cases of acute coronary syndrome is premature.1,2 In recent decades, discussion has focused on the profile of risk factors predisposing to premature acute coronary syndrome. In this issue of The Lancet Regional Health-Europe, Bugiardini et al., presented the results on 70,953 Caucasian patients with first acute coronary syndrome from 7 South Eastern European countries, participating in the International Survey of Acute Coronary Syndromes (ISACS) archives, who were compared with patients without any baseline traditional risk factors. The authors found the co-occurrence of smoking, arterial hypertension, diabetes, and hypercholesterolemia to be associated with a 5-year shorter life they found that current smoking increased the premature 3.96, and for men 2.82), hypercholesterolemia by about 40% (women RR 1.31; men RR 1.39) and diabetes increased the risk of premature death due to acute corcially in countries with high prevalence.