Age-Specific Cardiovascular Risk Factors for Major Adverse Cardiac Events in Patients Undergoing Myocardial Perfusion Imaging

Background: The prevalence of traditional cardiovascular risk factors shows differentage-specific patterns. It is not known whether the prognostic impact of risk factors is similarlyage-specific. We evaluated the profiles of cardiovascular risk factors and their prognostic impact oncoronary artery disease (CAD) in relation to age. Methods: We included 3667 patients with suspectedor known CAD undergoing stress myocardial perfusion imaging (MPI). We evaluated the risk formajor adverse cardiac events (MACE) within three years from the index MPI in patients belongingto three groups according to age tertile distribution: <59, 59-68, and >68 years. Gender, body massindex, diabetes, hypertension, dyslipidemia, family history of CAD, smoking, angina, dyspnea,previous CAD, and MPI outcome were assessed as risk factors by a multivariable Cox's regression.Results: The three-year risk of MACE increased progressively with age and was 9%, 13%, and 18%for each group, respectively (p < 0.0001). Dyspnea and abnormal MPI outcome were significant riskfactors for all age groups. Diabetes and smoking were significant from the age of 59 onwards, whilehypertension resulted significant for patients older than 68 years. Conclusions: The number of riskfactors was significantly associated with the occurrence of MACE increase with age. It is noteworthythat a personal history of CAD was not useful for risk stratification, while MPI results were.