Collet JP, Zeitouni M, Procopi N, et al. - Researchers analyzed young patients (age ≤ 45 years) having acute or stable obstructive coronary artery disease (CAD), to study the evolution of coronary atherosclerosis in these individuals and to determine the risk factors of poor consequences. Overall 880 patients with premature CAD were prospectively enrolled and followed. All-cause mortality, myocardial infarction, refractory angina requiring coronary revascularization, and ischemic stroke were all considered as the primary endpoint. The study sample comprised patients with 40.1 ± 5.7 years of age, predominantly men, smokers, with a family history of CAD or hypercholesterolemia. These people were observed for 20 years and during this time period, the occurrence of 399 ischemic events was reported in 264 patients and at least a second recurrent event was reported in 36%. Findings revealed high rates of recurrent events and mortality in cases with premature CAD. Despite the currently advised prevention measures, the aggressive nature of premature CAD was noticeable. Findings also revealed the link of ethnicity and concomitant inflammatory disease with poor prognoses, along with inadequate control of risk factors.