The significance of classical risk factors in coronary artery disease (CAD) remains unclear in older age due to possible changes in underlying disease pathologies. Therefore, we conducted Mendelian Randomization approaches to investigate the causal relationship between classical risk factors and primary CAD in different age groups. A Mendelian Randomization study was conducted in European-ethnicity individuals from the UK Biobank population. Analyses were performed using data of 22,313 CAD cases (71.6% men) and 407,920 controls (44.5% men). Using logistic regression analyses, we investigated the associations between standardized genetic risk score and primary CAD stratified by age of diagnosis. In addition, feature importance and model accuracy were assessed in different age groups to evaluate predictive power of the genetic risk scores with increasing age. We found age-dependent associations for all classical CAD risk factors. Notably, body mass index (OR 1.22 diagnosis < 50 years; OR 1.02 diagnosis > 70 years), blood pressure (OR 1.12 < 50 years; OR 1.04 > 70 years), LDL cholesterol (OR 1.16 < 50 years; OR 1.02 > 70 years), and triglyceride levels (OR 1.11 < 50 years; 1.04 > 70 years). In line with the Mendelian Randomization analyses, model accuracy and feature importance of the classical risk factors decreased with increasing age of diagnosis. Causal determinants for primary CAD are age dependent with classical CAD risk factors attenuating in relation with primary CAD with increasing age. These results question the need for (some) currently applied cardiovascular disease risk reducing interventions at older age.

© 2021. The Author(s), under exclusive licence to American Aging Association.

Overview publication

TitleClassical risk factors for primary coronary artery disease from an aging perspective through Mendelian Randomization.
DateJune 1st, 2022
Issue nameGeroScience
Issue numberv44.3:1703-1713
DOI10.1007/s11357-021-00498-9
PubMed34932184
AuthorsJansen SA, Huiskens B, Trompet S, Jukema J, Mooijaart SP, Willems van Dijk K, van Heemst D & Noordam R
KeywordsAging, Coronary artery disease, LDL cholesterol, Mendelian Randomization, Risk factors
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