Coronary artery disease in patients aged 35 or less - A different beast?

• Main Authors: T Christus, A M Shukkur, I Rashdan, T Koshy, M Alanbaei, M Zubaid, N Hayat, A Alsayegh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2011-01-01
• Series: Heart Views
• Subjects: Coronary artery disease; premature coronary artery disease; young patients; ethinicity
• Online Access: http://www.heartviews.org/article.asp?issn=1995-705X;year=2011;volume=12;issue=1;spage=7;epage=11;aulast=Christus

Aim: To assess the extent and severity of coronary artery disease (CAD) in 200 consecutive patients aged 35 years or less undergoing diagnostic coronary angiography. Patients and Methods: Findings in these 200 patients (≤ 35 years of age) were analyzed to find the extent and severity of CAD. The mean age was 31.69 (±3.76) years. Majority were males (94%) and from the Arab ethnicity (70.5%). Result: Smoking (71%) and history of premature CAD (27%) were the most frequent risk factors (RF). History of previous ST elevation myocardial infarction (MI) was present in 68%. Anterior wall MI was the most frequent location (63.3%). The majority (54.3%) had moderate or large size MI. Ejection fraction (EF) less than 50% was noted in 30.3%. Left main or triple vessel CAD was seen in 15%. One- and two-vessel CAD was seen in 32.5% and 19% patients, respectively. Coronary angiogram was completely normal in 23.5%. The majority (54.5%) were treated conservatively and the rest (45.5%) needed percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The mean number of stents used was 1.3 ± 0.67 and the mean length of stents used was 20.3 ± 12.6 mm. Conclusion: The extent and severity of CAD was very significant in this subgroup of very young (≤35 years) Asian patients. Smoking was the main risk factor and half of the patients needed either PCI or CABG.