There have been some interest in elevated c-reactive protein in cardiovascular disease. I'm not sure if its know whether its a a result of cad or if C-reactive protein is another risk factor. Some physicians have wondered if aspirin is so effective no only as an antiplatelet , but because it also posseses anti-inflammitory effects.
I can say that the number one risk factor i see daily is smoking, as you add the risk factors the age of incidence seems to go down.
The top risk factors are( no in any particular order)
Being male
Smoking
Diabetes
High lipids especially hdl
obesity
genetic family history
hypertension
The more of these you have the more severe and somtimes earlier and age of incidence.
For example the old guy who is 80 upon his first heart attack ( or myocardial infarction as we call it), smokes but has good family history and is not overweight or diabetic.
Then there is the 35 yearold with a heart attack, who smokes, is diabetic and poorly controled, gets no exercise and has high lipid panels , and a family history of Coronary Artery Disease.
2 patients with coronary artery disease and different age of incidents and possible even differences in severity based on compiling risk factors.
Its also possible a coincidence that those who don't take care of the rest of their body, also do not take care of their teeth.
There has been some studies of poor dental hygiene and valvular vegetation.
Most patients that need a valve replacement, if they have really bad gums and teeth, will be recommended if not required to have teeth pulled before surgery.
There are percutaneous valve replacements being done , I will ask if the same dental concerns exist.