Premature Atherosclerotic Heart Disease Definition and Guidelines

Standard Age Thresholds

The American College of Cardiology defines premature atherosclerotic heart disease as coronary artery disease occurring before age 55 years in men and before age 65 years in women, particularly when it affects first-degree relatives 1, 2, 3
Men with disease onset before age 55 years constitute premature coronary heart disease, according to the American College of Cardiology and American Heart Association guidelines 1, 2, 3
Women with disease onset before age 65 years constitute premature coronary heart disease, as defined by the American College of Cardiology and American Heart Association guidelines 1, 2, 3

The presence of a first-degree relative with coronary heart disease meeting the age criteria significantly elevates an individual's cardiovascular risk by 1.5- to 2.0-fold, independent of other traditional risk factors, as stated by the American Heart Association 2
Almost 75% of patients with premature CHD have a positive family history, demonstrating the strong hereditary component and opportunities for early prevention, according to the American Heart Association 2
The risk increases further with younger age of onset in the affected relative, increasing numbers of affected relatives, and closer genealogical proximity, as reported by the American Heart Association 2

Risk factor screening should be performed in all first-degree relatives of patients developing CHD before age 55 (men) or 65 (women), as recommended by the American Heart Association 3
Multifactorial cardiovascular risk will be higher than estimated from standard risk calculators in these individuals, according to the American Heart Association 3
When familial hypercholesterolemia is suspected, screening all first-degree relatives with full lipoprotein profiles is essential, as stated by the American Heart Association 3
The presence of any detectable coronary artery calcium in patients under age 50 years is associated with 5-fold increased coronary events and 3-fold increased cardiovascular events, although this fact is from Praxis Medical Insights, it is being included as there are no other sources for this specific fact 4