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Even with coronary revascularization and secondary prevention, individuals with premature coronary artery disease (CAD) are at high risk for recurrent events and death, with much of the risk attributable to poor risk-factor control.
The 880 patients prospectively studied in this trial, published online in the October 15 issue of the Journal of the American College of Cardiology, were younger than 45 years at the time of their first hospital admission for a coronary event. In the 20 years after their first event, 30% of patients with premature CAD had a second event. Most recurrences were nonfatal MIs (2.6 events per 100 patient-years), with all-cause death (1.6 per 100 patient-years) and stroke being less frequent (0.70 per 100 patient-years).