Atherosclerotic disease is the predominant aetiology of acute coronary syndrome in young adults

Cardiovasc J Afr. 2018;29(1):36-42. doi: 10.5830/CVJA-2017-035. Epub 2017 Dec 12.

Abstract

Objectives: Few studies have evaluated young adults in their third and fourth decades with coronary artery disease (CAD). This study evaluated the clinical and angiographic profile of young adults ( < 35 years) with CAD.

Methods: A 10-year (2003-2012) retrospective chart review was performed on patients less than 35 years diagnosed with CAD at Inkosi Albert Luthuli Central Hospital, Durban.

Results: Of the 100 patients who met the study criteria, the majority were male (90%), of Indian ethnicity (79%), and presented with acute coronary syndrome (93%). Smoking (82%), dyslipidaemia (79%) and dysglycaemia (75%) were the most prevalent risk factors. Almost half of the subjects (48%) met criteria for the metabolic syndrome. Angiographic findings revealed multi-vessel (42%), single-vessel (36%) and non-occlusive disease (20%); only two subjects had normal epicardial vessels. Disease severity was influenced by dyslipidaemia (p = 0.002) and positive family history (p = 0.002). Non-coronary aetiologies were identified in 19% of subjects.

Conclusion: Atherosclerotic disease associated with risk-factor clustering was highly prevalent in young adults with CAD.

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / epidemiology*
  • Adult
  • Age of Onset
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Dyslipidemias / epidemiology
  • Female
  • Glucose Metabolism Disorders / epidemiology
  • Humans
  • Life Style
  • Male
  • Metabolic Syndrome / epidemiology
  • Predictive Value of Tests
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • South Africa / epidemiology