The following is a summary of “Incidence of Atherosclerotic Cardiovascular Disease in Young Adults at Low Short-Term But High Long-Term Risk,” published in the February 2023 issue of Cardiology by An, et al.

Although the risk of atherosclerotic cardiovascular disease (ASCVD) among young individuals is low in the short term, it may be significant in the long run. For a study, researchers sought to compare how well short-term and long-term ASCVD risk prediction methods performed in predicting risk in young adults and assessed the incidence of ASCVD associated with anticipated short-term and long-term risk.

From 2008 to 2009, they included adults ages 18 to 39 in a U.S. integrated healthcare system and tracked them through 2019. They examined the incidence of ASCVD and computed the 10- and 30-year projected risk for the disease.

In 813 of the 414,260 young people, an incident ASCVD occurrence occurred over a median of 4 years (maximum 11 years). Although 30-year predicted risk had similar discrimination (Harrell’s C: 0.749 vs. 0.726) to 10-year predicted risk, reclassification was enhanced (net reclassification index: 16%). Overall, 1.0%, 2.2%, and 1.6% of young adults were classified as having low 10-year (≥7.5%) but elevated 30-year (≥20%) anticipated risk, respectively, and 1.6% as having low 10-year (<7.5%) but elevated 30-year predicted risk. The incidence rate of ASCVD per 1,000 person-years was 2.60 (95% CI: 1.92–3.52) for those with elevated 10-year predicted risk, 1.87 (95% CI: 1.42-2.46) for those with low 10-year but elevated 30-year predicted risk, and 0.32 (95% CI: 0.30-0.35) for those with low 10-year and 30-year predicted risk. Those with low 10-year but elevated 30-year anticipated risk were compared to those with low 10-year and 30-year predicted risk using an age- and sex-adjusted incidence rate ratio of 3.04 (95% CI: 2.25-4.10).

An additional subgroup of young adults with elevated observed risk despite low anticipated short-term risk was further distinguished by long-term ASCVD risk prediction techniques.

Reference: jacc.org/doi/10.1016/j.jacc.2022.11.051