Young adult cardiovascular diseases: a single center coronary computed tomography angiography study

Cardiovascular disease (CVD) is one of the leading causes of death. However, the prevalence of CVD in young adults (<40 years of age) has not been well documented. We conducted this study to determine the proportion of CVD in both symptomatic and asymptomatic young adults.

Coronary CT angiography images obtained from April 2015 to July 2017 in our institution was retrospectively reviewed. Young adults were separated into two groups according to whether they had experienced chest discomfort. The diagnosis was classified as normal, coronary artery disease (CAD), myocardial bridging (MB), congenital coronary anomaly, congenital cardiac anomaly, cardiomyopathy, and aortic anomaly. The proportion of different diagnoses in two groups and cardiovascular risk factors were analyzed.

Totally 107 patients (mean age, 35.6 ± 3.55 years) were grouped into 36 cases of symptomatic group and 71 patients of asymptomatic group. Cardiovascular anomalies were found in 61 cases (41%). No significant difference in the occurrence rates of CAD (14% vs 11%, p = 0.53), MB (31% vs 42%, p = 0.51), and congenital coronary anomaly (7% vs 3%, p = 0.26) between groups. Mild arterial stenosis was implied in most CAD cases. Hypertension was the only risk factor significantly correlated with CAD.

Although young adults are conventionally identified as low-risk, more than 60% of the cases in our cohort were proved to present cardiovascular anomalies, with no significant relation to cardiac symptoms. Early interventions should be conducted for aggressive CVD subtypes to prevent future acute events.