{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:29:13Z","timestamp":1787754553797,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2023ZD0503702"],"award-info":[{"award-number":["2023ZD0503702"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2024M763762"],"award-info":[{"award-number":["2024M763762"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early\u2010onset ischemic heart disease (IHD) is a growing global threat, with tobacco exposure as a key modifiable risk factor. A global assessment of its tobacco\u2010attributable burden is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Global Burden of Disease Study 2023 data, we assessed tobacco\u2010attributable deaths and disability\u2010adjusted life years (DALYs) from early\u2010onset IHD in 204 countries and territories during 1990\u20132023. Trends were evaluated using estimated and average annual percentage changes (EAPCs and AAPCs). Age\u2010period\u2010cohort (APC) models characterized age, period, and cohort patterns, and Bayesian APC models projected age\u2010standardized rates to 2050. A sensitivity analysis compared the sexes aged 40\u201354 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2023, tobacco\u2010attributable DALYs increased from 15.21 to 17.12 million and deaths from 342\u2009900 to 386\u2009300. Conversely, ASDR declined from 381.54 to 221.82 per 100\u2009000 (EAPC \u22121.84%, 95% CI \u22121.94 to \u22121.73) and ASMR from 8.69 to 4.96 per 100\u2009000 (EAPC \u22121.88%, 95% CI \u22121.98 to \u22121.77). Male rates remained higher, including when both sexes were restricted to ages 40\u201354 years. APC analyses showed significant favorable net drifts and lower period and cohort rate ratios in recent periods and birth cohorts. Bayesian projections suggested declining ASDRs through 2050, whereas ASMR estimates were stable or slightly increased with widening uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The age\u2010standardized burden of tobacco\u2010attributable early\u2010onset IHD declined substantially between 1990 and 2023, but absolute DALYs and deaths increased and disparities by development level and sex persisted. Stronger tobacco control and integrated cardiovascular prevention are needed, particularly for high\u2010risk males and in low\u2010 and middle\u2010SDI settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70451","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:56:18Z","timestamp":1787568978000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tobacco\u2010Attributable Burden of Early\u2010Onset Ischemic Heart Disease From 1990 to 2023: A Global Analysis Using GBD 2023 and Age\u2010Period\u2010Cohort Modeling"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2467-079X","authenticated-orcid":false,"given":"Xin","family":"Ouyang","sequence":"first","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"He","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China"},{"name":"Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingbin","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China"},{"name":"Department of Cardiology, Guangdong Provincial 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