Coronary Artery Disease among Patients Younger than 35 Years of Age

Abstract

Background: Coronary artery disease (CAD) and its major manifestation of acute myocardial infarction (MI) are considered as the most common causes of morbidity and mortality worldwide. MI in very young group of age is a significant issue to focus on, however there is a scarcity of data on premature coronary heart diseases-acute MI (AMI) in this group of age. This may underestimate the important difference that exists between young and old groups of age. Objective: The main aim of this study is to evaluate the most common risk factors, including hyperlipidemia, smoking, diabetes mellitus (DM), hypertension, and positive family history of AMI with their angiographic profile, among Iraqi patients of <35 years old. Materials and Methods: This study was enrolled in Surgical Specialty Hospital-Cardiac Center, Erbil, Iraq among 100 consecutive patients (77 males and 23 females) between November 2016 and December 2017 of those whose age was ≤35 years. Results: The mean age was 31.6 ± 2.91 years with an age range of 24–35 years. The incidence of AMI was significantly higher in male patients than females. The most common risk factors were hyperlipidemia (51%), smoking (49%), family history of premature CAD (44%), hypertension (25%), and DM (22%). The most common symptom and presentation of CAD was chest pain and anterior wall myocardial infarction, 67% and 64% respectively. About 56% of all the included patients who underwent Coronary Angiography, had obstructive CAD and among this group 89.2% had single vessel disease, 5.35% had three vessel disease, 3.57% had double vessel disease and 1.78% had abnormal characteristic of coronary artery (Muscle Bridge). The most common involved artery was the left anterior descending (LAD) (36%), followed by the right coronary artery (9%). Based on the electrocardiogram findings, 42% of the patients presented with ST-segment elevation myocardial infarction. Conclusion: CAD in patients younger than 35 years occurred more in the male gender. Hyperlipidemia was the most common risk factor among all the patients' and AWMI owing to the LAD artery was the most common presentation.