Young Patients With Coronary Heart Disease Trial- Assessment of Risk Factors and the Impact of a Risk Reduction Program

After enrollment, participants will meet with researchers where baseline character-istics will be obtained including biometrics such as weight, height, blood pressure, abdominal circumference, etc., as well as a questionnaire that will include validat-ed screening tools for the screening for depression, anxiety, and stress, which are considered non-traditional risk factors for heart disease. The questionnaire will also include other aspects of the participant's lifestyle that could help better understand their risk for heart disease. This questionnaire will be available to be filled out on paper, via email which will be linked with REDCap, and in a tablet provided by our team with the data also being uploaded directly to REDCap.

Blood will also be collected by venipuncture (approximately 12milliliters, 6-8mL for standard of care labs, and 3-4mL for research labs) to assess inflammatory markers, lipids and glucose levels. If based on this initial screening, participants are thought to be at high risk for genetic disease, which likely predisposed them to develop heart disease, they will be offered genetic testing as part of their routine clinical care outside of this research, and an additional consent form will then be provided. We are planning to only recommend genetic testing as per clinical care in those for whom it is recommended by clinical guidelines. When a patient is deemed eligible from a clinical standpoint, they will be referred to our cardio ge-nomics team and be consented as per their clinical protocols and samples, either saliva or blood acquired by venipuncture (about 5ml), will be obtained. Source of sample will be determined by cardio genomics team and this will also fall under their standard of care. If the patient is being enrolled in the outpatient setting and has lab work within the past month, assuming no changes have been made to lipid lowering therapies during that time, we will only need to draw 3-4mL for research labs and possibly one additional tube for Lipoprotein A, as it is not commonly in-cluded in basic lab work.

During their initial consultation while in the hospital, their individual risk would be assessed and the patient will receive counseling on how to further improve said risk. These goals will be reinforced and measures to ensure those goals are met will be implemented when the patient comes to clinic within 2 weeks from their cardiac catheterization. During that visit, they will also be educated on the process of heart disease. Frequency of follow up in clinic will be determined on an individual basis based on individual risk factors, however, all patients are expected to be seen for a minimum of 3 times during those 6 months.

Soon after seeing us for that initial visit in clinic, the group risk reduction program will begin and will last for 6 months with 2 sessions per month (every other week), out of which participants will be required to attend at least 6 for maximum benefit. The sessions will include an exercise and nutrition program.

The nutrition program will be given by a Registered Dietitian Nutritionist and it will consist of a 60min session that will include about 10-15min education, 30min for a cooking demonstration where participants will be able to participate in the process of making heart healthy foods, and 10-15min for questions and answers. Food al-lergies will be reviewed prior to initiation of each session.