Comparison of Clinical and Angiographic Profile by Chronological Age and Vascular Age in Patients Presenting First Acute Myocardial Infarction

A BSTRACT Background: Vascular age (VA), derived from the systematic coronary risk evaluation (SCORE) algorithm, has been shown to communicate cardiovascular risk effectively. This study aimed to assess the VA of patients presenting with their first acute myocardial infarction (AMI) and to correlate it with the severity and extent of coronary artery disease (CAD). Methods: We recruited 512 consecutive patients presented with AMI. VA was derived using the SCORE project algorithm and compared with the chronological age (CA). Clinical characteristics, cardiovascular risk factors, patterns of coronary artery involvement, and outcomes were analyzed in relation to both CA and VA. Results: The mean CA was 59.9 ± 9.4 years, and the mean VA was 68.1 ± 11.8 years, with a mean difference of 8.2 ± 4.7 years. Patients were stratified into young (36.7%) and older (63.3%) CAD groups. The young group had a mean CA of 50.7 ± 6.5 and VA of 57.1 ± 9.2 years (difference: 6.4 ± 4.4), while the older group had a CA of 65.3 ± 6.0 and VA of 74.5 ± 7.3 years (difference: 9.2 ± 4.5). The VA–CA gap was greater in older patients, who also had more multivessel disease. Patients with a VA–CA difference >8 years had more severe CAD, with higher rates of triple-vessel (23.2% vs. 17.4%) and two-vessel disease (29.9% vs. 16.7%). Conclusions: VA was more closely associated with the severity of CAD than CA. A greater difference between VA and CA was associated with more extensive CAD, particularly multivessel involvement. These findings underscore the utility of VA as a more accurate marker for cardiovascular risk stratification and support its integration into routine clinical assessments and preventive strategies.