Clinico-Epidemiological and Angiographic Profiles of Patients With Premature Acute Coronary Syndrome

Document Type : Original Article


1 Department of Biochemistry, BLDE (DU), Shri B M Patil Medical College, Hospital and Research Center, Vijayapura, Karnataka, India.

2 Department of Cardiology, BLDE (DU), Shri B M Patil Medical College, Hospital and Research Center. Vijayapura, Karnataka, India.


Background:Indians are more susceptible to young acute coronary syndrome (ACS), with about a fourth of the inflicted population below 40 years of age. However, the Indian population is diverse and the need for population-specific characteristics cannot be emphasized. We sought to determine the clinico-epidemiological profile of cases with young ACS among the regional population.
Methods:The present prospective observational study was carried out in a high-volume tertiary cardiac care center in north Karnataka. Patients aged below 40 years who were hospitalized with acute myocardial infarction between 2017 and 2019 to undergo invasive cardiac procedures were studied for clinico-epidemiological features. Data were analyzed using SPSS, version 23.0, and Microsoft Office 2007. All the patients’ characteristics were summarized descriptively.
Results:The mean age of the study population was 36.23±3.89 years, and men were more inflicted than women (75.9% vs 24.1%). The urban population was affected more than the rural population (60.2% vs 39.8%). Most of the study population presented with chest pain (83.5%). Angiography revealed significant single-vessel disease with the involvement of the left anterior descending artery (50.3%). The common complications noted were mitral regurgitation (29.32%) and heart failure (25.5%).
Conclusions: Young ACS is almost confined to men, and chest pain is the main presentation. Single-vessel disease is more common with the left anterior descending artery being the most involved vessel. (Iranian Heart Journal 2021; 22(2): 38-43)


  1. Jalowiec DA, Hill JA. Myocardial infarction in the young and in women. Cardiovascular clinics. 1989; 20(1):197.
  2. Avezum A, Makdisse M, Spencer F, Gore JM, Fox KA, Montalescot G, Eagle KA, White K, Mehta RH, Knobel E, Collet JP. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). American heart journal. 2005 Jan 1; 149(1):67-73.
  3. Haque AF, Siddiqui AR, Rahman SM, Iqbal SA, Fatema NN, Khan Z. Acute coronary syndrome in the young-risk factors and angiographic pattern. Cardiovascular Journal. 2010;2(2):175-8.
  4. Chandrakasu A, Jayachandran A, Meyyappan C, Narayan G, Nayar PG, Bari AB. Clinical and angiographic profile of coronary artery disease among young south Indian males. Kerala Heart Journal. 2016 Dec 31; 6(2).
  5. Colkesen AY, Acil T, Demircan S, Sezgin AT, Muderrisoglu H. Coronary lesion type, location, and characteristics of acute ST elevation myocardial infarction in young adults under 35 years of age. Coronary Artery Disease. 2008 Aug 1; 19(5):345-7.
  6. Sharma M, Ganguly NK. Premature coronary artery disease in Indians and its associated risk factors. Vascular health and risk management. 2005 Sep; 1(3):217.
  7. Deora S, Kumar T, Ramalingam R, Manjunath CN. Demographic and angiographic profile in premature cases of acute coronary syndrome: analysis of 820 young patients from South India. Cardiovascular diagnosis and therapy. 2016 Jun; 6(3):193.
  8. Mackay J, Mensah GA. The atlas of heart disease and stroke. World Health Organization; 2004.
  9. Shah N, Kelly AM, Cox N, Wong C, Soon K. Myocardial infarction in the “young”: risk factors, presentation, management and prognosis. Heart, Lung and Circulation. 2016 Oct 1; 25(10):955-60.
  10. Noeman A, Ahmad N, Azhar M. Coronary artery disease in young: Faulty life style or heredofamilial or both. Annals. 2007; 13(2):162-4.
  11. Klein LW, Agarwal JB, Herlich MB, Leary TM, Helfant RH. Prognosis of symptomatic coronary artery disease in young adults aged 40 years or less. The American journal of cardiology. 1987; 60(16):1269-72.
  12.  Awan ZA, Hafizullah M. Myocardial infarction in young versus older adults: clinical characteristics and angiographic features. J Ayub Med Coll Abbottabad. 2010; 22(2).
  13.  de Abreu M, Silberstein A, Mariani J, Cosarinsky L, Gagliardi JA, Doval HC, et al. Clinical and Angiographic Characteristics, Therapeutic Strategies and Outcome of Young Patients with Acute Coronary Syndrome. Argentine Journal of Cardiology. 2012;81(1):22-30.
  14. Dicker D, Feldman BS, Leventer-Roberts M, Benis A. Obesity or smoking: Which factor contributes more to the incidence of myocardial infarction? European journal of internal medicine. 2016 Jul 1; 32:43-6.
  15.  Arumugam chandrakasu, avinash jayachandran, chokkalingam meyyappan, ganesh narayan, pradeep gopinath nayar,ahamed basha abdul bari.Clinical and angiographic profile of coronary artery disease among young south indian males kerala heart j 2016; 6(2):xx-xx.
  16. Ambroziak M, Niewczas-Wieprzowska K, Maicka A, Budaj A. Younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature atherosclerosis. BMC Cardiovascular Disorders. 2020 Dec; 20(1):1-9.
  17. Tewari S, Kumar S, Kapoor A, Singh U, Agarwal A, Bharti BB, Garg N, Goel PK, Sinha N. Premature coronary artery disease in North India: an angiography study of 1971 patients.
  18. Christus T, Shukkur AM, Rashdan I, Koshy T, Alanbaei M, Zubaid M, Hayat N, Alsayegh A. Coronary artery disease in patients aged 35 or less–a different beast?. Heart Views: The Official Journal of the Gulf Heart Association. 2011 Jan; 12(1):7.
  19. Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, Eagle K. Acute myocardial infarction in the young—The University of Michigan experience. American heart journal. 2002 Jan 1; 143(1):56-62.