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Year : 2019  |  Volume : 5  |  Issue : 1  |  Page : 18-25

Acute coronary syndrome in young - A tertiary care centre experience with reference to coronary angiogram

1 Department of Cardiology, ASRAM Medical College, Eluru, Andhra Pradesh, India
2 Department of General Medicine, ASRAM Medical College, Eluru, Andhra Pradesh, India

Correspondence Address:
Dr. Tammiraju Iragavarapu
Department of Cardiology, ASRAM Medical College, Eluru - 534 005, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcs.jpcs_74_18

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Background: Acute coronary syndrome (ACS) is a potentially life-threatening condition which is more common in elderly people, and young are relatively protected. Currently, the protective effect on young from coronary artery disease (CAD) is taken away by several risk factors. The aim of this study is to determine the conventional risk factors and angiographic correlation of CAD in young age (<40 years) to that of elderly age (>40 years). Materials and Methods: This study was a hospital-based retrospective cross-sectional analytical study involving 1151 patients of ACS admitted in the cardiac ICU from May 2016 to May 2018. Among these patients, coronary risk factors such as smoking, diabetes, hypertension, dyslipidemia, and family history were studied. Patients were divided into two groups, Group A: <40 years and Group B: >40 years. Patients were evaluated angiographically. The significance of each risk factor between the groups was calculated by employing the Chi-square test and P < 0.05 was taken as statistically significant. Results: A total of 1151 cases were included in the study, of which 120 cases were <40 years of age. The prevalence of CAD in young in our study is 10.42% with male preponderance. P value is statistically significant (P < 0.05) among younger individuals for smoking, dyslipidemia, obesity, family history. Of 120 cases with critical CAD, single-vessel disease (SVD), predominantly the left anterior descending artery, was the most prevalent. SVD and recanalized coronaries were statistically significant among younger group whereas triple-vessel disease (TVD) is statistically significant among the elderly. Thrombus burden is more in young when compared to the elderly. Conclusion: Although ACS is a less common entity in young adults aged 40 years or less, recent epidemiological trend is progressing and it constitutes an important challenge both for a patient and for a treating physician. Young patients with CAD are mainly males, and SVD is more common. Emphasis should be given on diagnosis and management of risk factors in this vulnerable group to prevent mortality and morbidity.

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