Risk factors for acute coronary syndrome in patients below the age of 40 years

Abstract

BackgroundAcute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Plasma markers of inflammation have been recently identified as diagnostic aid and risk predictors. The present study, conducted in Slemani Cardiac Hospital (SCH), Sulaimaniyah, Iraq aimed to recognize some risk factors for ACS in Iraqi adults younger than 40.MethodologyThis is a prospective case-control study of 100 patients with ACS vs. a control group of 100 healthy volunteers. The study began at 1st January 2014 and ended at 31st December 2016. All patients were subjected to full history taking, clinical examination including measurement of waist circumference and body mass index (BMI). Investigations included electrocardiography (ECG), echocardiography, full blood count, measurement of lipid profile and C-reactive protein (CRP). The patients were managed by percutaneous coronary intervention (PCI).ResultsThe mean age of the patients was 36 years (range 28–40). Eighty-five% of patients were male. The mean BMI (29 kg/m2) and waist circumference (98 cm) of the patients were higher than the controls (24 kg/m2 and 72 cm respectively). The leukocytes, lymphocytes and neutrophil counts as well as CRP in both groups were within the normal range. The most prevalent risk factor was obesity (n = 86). Other risk factors were smoking (n = 62), hypertension (n = 26), diabetes mellitus (n = 22) and positive family history of ACS (n = 24). Most patients (n = 83) had multi-vessel coronary artery disease (2–3 vessels).ConclusionACS in young adults is an increasing health problem. Obesity was found to be the most prevalent risk factor.

Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq

“…They concluded that obesity, smoking, number of diseased vessels, hypertension, family history of ACS, and diabetes mellitus were, sequentially, the most frequent risk factors for ACS. 30 This finding is also in line with many other previously conducted studies that have referred to smoking, hypertension, diabetes, obesity, and dyslipidemia as risk factors for the development of ACS. [31][32][33][34] Chest pain has been introduced as the most common presentation of an ACS.…”

“…This finding is in good agreement with previous studies that have referred to male gender as a risk factor for ACS. 26,[28][29][30] Hypertension was found to be the most frequent risk factor among the studied AMI patients, such that 65 cases (54.4%) had hypertension. Other most frequent risk factors were observed to be dyslipidemia (52%), smoking (42.4%), diabetes mellitus (38.4%), obesity (24%), family history (14.4%), and physical inactivity (3.2%).…”

Risk factors for coronary artery disease in young patients with stable angina pectoris

“…In order to provide earlier and better diagnosis of CAD in young adults, novel risk factors and markers have been evaluated in the literature [6][7][8]. However, these studies included specific cohorts, such as ACS [6][7][8][9]. Therefore, we aimed to investigate the relationship between traditional and nontraditional risk factors and the presence of significant atherosclerosis in a young population with SAP.…”

Acute myocardial infarction among young adults under 40 years of age. Risk factors, clinical and angiographic characteristics

“…Even though ischemic heart disease is considered a disease of the older population 7 premature CAD remains a signifi cant cause of morbidity and mortality in the world. 8 AMI in the young individuals represent a small but yet an important group to study its specifi cities in the era of preventive cardiology.…”