Acute Myocardial Infarction in Young Individual: The Startling Reality of Coronary Progeria

Abstract

Objective: To study the epidemiology and clinical silhouette, risk prole, angiographic patterns, management, and long term outcomes of Corononary artery disease presenting as an ACS(cute coronary syndrome) in young individuals of age less than 40 years presenting to our tertiary care centre. Methods: We incorporated 251 patients aged less than 40 years who presented with ACS (STEMI or NSTEMI/UA) to the department of cardiology Coimbatore Medical College, Coimbatore. Results: 251 young patients aged 40 years or less who presented with ACS were included in the study. Smoking turned out to be the most deadly risk factor and was associated with the most number of cases present in 68% of cases. Next in line was diabetes (54%) and family history (48%) of cases. 54% patients were reported to be having signicant depression.Hypertension (44%)and dyslipidemia (40%) were also seen in a large proportion of cases. Most of the cases presented as STE-ACS (80%) and other presented as NSTE-ACS(20%). Out of 251 patients 178 patients underwent CAG, of all the patients undergoing Coronary angiogram most recurring angiographic prole was that of being Single vessel disease (65%) mostly involving the LAD. There was in-hospital mortality of 4 patients, one of which had presented with concomitant diabetic ketoacidosis. Most common complication of the patients was Cardiogenic shock which occurred in 22% of the patients, while 18% of them had post MI period complicated by Arrhythmias. Conclusions: STE-ACS was the most common presentation of ACS in the young population. Smoking was the most common risk factor. The majority of the patients had single-vessel disease. Our study concluded that modiable risk factors are the most penetrative factors which could be dealt with in an ideational manner to reduce the relative risk of CAD in young