Global Burden of Early-Onset Ischemic Heart Disease, 1990 to 2019.

Background: Early-onset ischemic heart disease (IHD) is a growing burden associated with high disability and death. Objectives: This study aimed to estimate the burden of incidence, prevalence, and disability-adjusted life years (DALY) of early-onset IHD from 1990 to 2019. Methods: Data on the burden of early-onset IHD (men<55 years, women<65 years), including prevalence, incidence, DALY, and deaths, were collected from the Global Burden of Disease study for 204 countries and territories from 1990 to 2019. Results: In 2019, early-onset IHD affected 5.34 million (95% uncertainty interval [UI]: 3.96-6.96) individuals globally. This resulted in 58.48 million (95% UI: 52.65-64.69) DALY and 1.44 million (95% UI: 1.29-1.59) deaths. Countries with a middle sociodemographic index (SDI) had the highest incidence cases (1.79 million, 95% UI: 1.32-2.34) and the low-middle SDI countries had the highest age-standardized incidence rate of 179.34 per 100,000 (95% UI: 134.38-231.94). Low-middle SDI countries exhibited the highest age-standardized death rate (57.13 per 100,000, 95% UI: 48.45-66.53) and age-standardized DALY rate (2,309.67 per 100,000, 95% UI: 1962.31-2,693.93). Globally, female incidence cases (2.77 million, 95% UI: 2.04-3.64) surpassed male (2.57 million, 95% UI: 1.92-3.32). The top 2 attributable risk factors were high low-density lipoprotein cholesterol and high systolic blood pressure. Conclusions: The global incidence rate of early-onset IHD decreased from 1990 to 2019. The incidence rate was highest in low-middle SDI countries, and the burden of DALY was highest in low-middle SDI countries. The DALY and death rate were higher in men. High low-density lipoprotein cholesterol and high systolic blood pressure were the primary attributors.