Newer perspectives of coronary artery disease in young

Abstract

Coronary artery disease (CAD) occurring in less than 45 years of age is termed as young CAD. Recent studies show a prevalence of 1.2% of CAD cases in this age group. Ethnic wise south Asians especially Indians are more vulnerable to have CAD in young age group with a prevalence of 5% to 10%. Conventional risk factors such as smoking, diabetes, hypertension, obesity and family history seems to be as important as in older CAD subjects. But the prevalence of these risk factors seems to vary in younger subjects. By far the most commonly associated risk factor is smoking in young CAD. Several genes associated with lipoprotein metabolism are now found to be associated with young CAD like cholesterol ester transfer protein (CETP) gene, hepatic lipase gene, lipoprotein lipase gene, apo A1 gene, apo E gene and apo B. Biomarkers such as lipoprotein (a), fibrinogen, D-dimer, serum Wnt, gamma glutamyl transferase, vitamin D2 and osteocalcin are seems to be associated with premature CAD in some newer studies. In general CAD in young has better prognosis than older subjects. In terms of prognosis two risk factors obesity and current smoking are associated with poorer outcomes. Angiographic studies shows predominance of single vessel disease in young CAD patients. Like CAD in older person primary and secondary prevention plays an important role in prevention of new and further coronary events.

Traditional Cardiovascular Risk Factor and Psychosocial Distress in Younger Coronary Patients: Delineating a Comprehensive Approach for Secondary Prevention

“…A cohort of more than 1,000 patients with newly diagnosed CAD was selected, thus allowing an in-depth evaluation of any relevant difference between younger and older patients. In accordance with previous studies [4, 6], younger CAD patients were found to be more frequently males, active smokers, obese, with higher levels of LDL cholesterol, and lower functional capacity. Besides, these younger subjects were also less likely to be treated with statins and aspirin at the time of coronary angiography.…”

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

“…However, report on the association between hypertension and TB in young STEMI patients remains scanty. Previous study found that the prevalence of hypertension was 25% in young CAD patients as compared with 13% in comparable age group without CAD, and the prevalence of hypertension was much higher in elderly CAD individuals as compared with young CAD patients . Several studies also reported an increasing trend of the prevalence of hypertension in young CAD patients .…”

“…Previous study found that the prevalence of hypertension was 25% in young CAD patients as compared with 13% in comparable age group without CAD, and the prevalence of hypertension was much higher in elderly CAD individuals as compared with young CAD patients. 36 Several studies also reported an increasing trend of the prevalence of hypertension in young CAD patients. 36,37 Our results indicate that the prevalence of hypertension is significantly higher in patients with HTB than in patients with LTB (75.0 vs. 17.1%, P < 0.001).…”

Risk factors of premature coronary artery disease in Iran: A systematic review and meta‐analysis

“…Hypertension is one of the leading causes of PCAD and death . In the study conducted by Aggarwal et al, the prevalence of hypertension was higher in young CAD patients (25%) compared to individuals without CAD (13%) . In a study on Indian population, hypertension was identified as a modifiable risk factor for inpatients younger than 55 years of age with heart disease.…”