Some conditions are known to be associated with an elevated risk of coronary disease. Patients known or suspected of having any of these may require specific testing and treatment:
Chronic kidney disease (CKD) — This is considered an independent risk factor for coronary artery disease.
Systemic lupus erythematosus (SLE) — There is a higher prevalence of atherosclerotic cardiovascular disease in SLE. Cardiovascular disease is the most common cause of mortality in SLE.
Rheumatoid arthritis (RA) — Patients with RA have 1.5 to 2.0 times the risk of coronary artery disease as those without it.
Inflammatory bowel disease (IBD) — A higher risk of coronary disease may result from the chronic inflammatory state seen in IBD.
Human immunodeficiency virus (HIV) — Again a 1.5 to 2-fold increased risk of coronary artery disease thought to arise from the pro-inflammatory state.
Psoriasis — Patients with psoriatic disease have a higher risk of myocardial infarction, stroke and cardiovascular mortality. This patient population needs regular screening of lipid levels, blood pressure and glycemic control and may benefit from a lower threshold for statin therapy. Having psoriasis involving more than 10% of body surface area is an indicator of particularly high risk.
History of Cocaine use — Cocaine stimulates the adrenergic system by blocking uptake of norepinephrine. This results in tachycardia, hypertension and coronary vasospasm immediately following use. Cocaine also inhibits several ion channels increasing the risk of dangerous arrhythmias like ventricular tachycardia. Chronic cocaine use has been shown to cause premature coronary atherosclerosis, even in young users.