Pattern of Coronary Angiography in Young Adults versus Older Adults Presented by Coronary Artery Disease in Correlation to Their Risk Factors with 1-year Follow-up of Their Clinical Outcome

Abstract

Abstract Background: Coronary artery disease (CAD) is a leading cause of mortality worldwide, with varying patterns and risk factors across different age groups. While CAD is common in older adults, data on young adults are limited, with traditional risk factors and familial history playing a significant role in early disease development. The purpose of this study was to compare the coronary angiographic patterns in young adults (<40 years) and older adults (≥40 years) presented with CAD, assess the correlation with risk factors, and monitor clinical outcomes after 1 year. Patients and Methods: This retrospective cohort study was conducted at the National Heart Institute, including 2204 consecutive patients undergoing coronary angiography and/or percutaneous coronary intervention for CAD from January 2019 to January 2020. Patients were divided into two groups based on age: group A (<40 years) and Group B (≥40 years). Angiographic findings, risk factors, and clinical outcomes were assessed and compared. Results: Group B had significantly higher rates of hypertension (63.6% vs. 22.2%, P < 0.001), diabetes (53.5% vs. 24.1%, P < 0.001), and female gender (29% vs. 11.1%, P < 0.001) compared to Group A. Group A showed higher smoking rates (70.4% vs. 46.5%, P < 0.001) and positive family history (42.6% vs. 4.4%, P < 0.001). Angiographic findings revealed higher rates of single-vessel affection, coronary ectasia, aneurysm, and slow flow phenomenon in Group A, whereas Group B demonstrated more bifurcation lesions, chronic total occlusion, and calcification. Conclusions: This study highlights the need for age-specific approaches in managing CAD, with younger patients showing early disease onset and older patients exhibiting more complex disease. Tailored cardiovascular care is essential, focusing on lifestyle modifications in younger adults and managing metabolic conditions in older adults.