Coronary Artery Disease

Excerpt

Coronary artery disease (CAD) is characterized by the development of atherosclerosis in the coronary arteries, which can sometimes be asymptomatic. Coronary heart disease (CHD), also known as ischemic heart disease (IHD), encompasses conditions such as stable angina, acute coronary syndrome (ACS), and silent myocardial ischemia. Mortality associated with CHD is mainly due to CAD. ACS is typically symptomatic and includes conditions like unstable angina and myocardial infarction. For clarity, we will refer to CHD as "CAD" throughout this discussion.

CAD is the leading single cause of death and disability-adjusted life years (DALYs) lost worldwide. This burden disproportionately affects low- and middle-income countries, contributing to approximately 7 million deaths and 129 million DALYs annually. In 2015, CAD was responsible for 8.9 million deaths and 164.0 million DALYs globally. Individuals who survive myocardial infarction face a significantly higher risk of recurrent events and have an annual mortality rate 5 to 6 times higher than people without CAD.

CAD is marked by an inadequate supply of blood and oxygen to the myocardium. The condition arises from occlusion of the coronary arteries and results in a demand-supply mismatch of oxygen. CAD typically involves the formation of plaques in the lumen of coronary arteries that impede blood flow.

CAD is the major cause of death in the US and worldwide. CAD was an uncommon cause of death at the beginning of the 20th century. Deaths due to CAD peaked in the mid-1960s and then decreased. However, This disease is still the leading cause of death worldwide. The likelihood of death from CAD increases substantially with age. Among the modifiable risk factors, systolic blood pressure plays a crucial role, accounting for a portion of the heightened CAD risk associated with aging.