Symptomatic coronary artery disease in patients aged 21 to 30 years

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Obstructive coronary artery disease (CAD) is increasingly diagnosed in young individuals.
• Understanding risk factors in this demographic is crucial for early intervention and prevention strategies.

Purpose of the Study:

• To identify the prevalence of risk factors in young adults with obstructive coronary artery disease (CAD).
• To compare risk factor profiles between young men with CAD and a healthy control group.

Main Methods:

• Retrospective review of 101 young individuals (≤30 years) with arteriographically confirmed obstructive CAD.
• Comparison of risk factor prevalence, including smoking, family history, and serum cholesterol, with an age- and catheterization-matched control group.
• Analysis of CAD severity (1-, 2-, or 3-vessel disease) and left main coronary artery involvement.

Main Results:

• Significant risk factors identified in the young CAD group were cigarette smoking (p = 0.001) and familial CAD (p = 0.002), particularly when manifested before age 50 (p = 0.005).
• Serum cholesterol was significantly higher in the CAD group (p = 0.0001), though 54% remained below 250 mg/dl.
• Arteriography revealed 1-vessel disease in 57, 2-vessel in 21, and 3-vessel disease in 22 patients.
• One-year mortality was 3%, and 5-year mortality was 20%, predominantly from cardiac causes like myocardial infarction and sudden death.

Conclusions:

• Cigarette smoking and a family history of early-onset CAD are significant risk factors in young adults.
• Elevated cholesterol levels, even below 250 mg/dl, are associated with obstructive CAD in this population.
• Mortality rates in young adults with obstructive CAD are substantial, emphasizing the need for aggressive risk factor management and early detection.