PATTERN OF CORONARY ARTERY DISEASES IN PATIENTS UNDER 40 YEARS OF AGE WITH ACUTE CORONARY SYNDROME

Abstract

Objectives: To determine the pattern of coronary artery diseases (CAD) in patients under 40 years of age with acute coronary syndrome (ACS) presenting at Hyderabad Satellite Center of National Institute of Cardiovascular Disease (NICVD), Pakistan.

Methodology: This cross-sectional study was conducted at cardiology department of the NICVD, Hyderabad Satellite Center. Both male and female patients, between 18 to 40 years of age, diagnosed with acute coronary syndrome (ACS), and undergone coronary angiography were included in this study. Angiographic patterns in terms of extent of the disease (number of diseased vessels and localization of lesion) were assessed.

Results: Total of 220 young patients included. Patients were predominantly male (91.8%) with the mean age of 35.3 ± 5 years. Smoking was observed 30.5% followed by hypertension (24.5%) and positive family history of CAD (19.1%). A majority of the patients (79.1%) were diagnosed as with ST-elevation myocardial infarction (STEMI) with anterior wall myocardial infarction (MI) as the most common (57.3%) type of MI. Most of the patients (70%) had single vessel diseases (SVD) with left anterior descending artery (LAD) as the most commonly diseases vessel (53.6%). Nine (4.1%) patients had significant left main disease and 6.4% had non-obstructive CAD.

Conclusion: The common clinical presentation of ACS in younger patients is STEMI. Smoking is the commonest risk factor followed by hypertension and family history of CAD. More than 2/3rd of the young patients are expected to have single vessel diseases with LAD as the most commonly diseased vessel.