Document Type : Original Article
National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
National Institute of Cardiovascular Diseases (NICVD), Sehwan, Pakistan.
National Institute of Cardiovascular Diseases (NICVD), Hyderabad, Pakistan.
Background: Acute coronary syndrome (ACS) is a rapidly growing concern, especially among younger urban communities. We aimed to study age-based differences in clinical and angiographic profiles and outcomes in an urban population.
Methods: This study recruited 2 independent, equal-sized cohorts of consecutive patients with ACS undergoing coronary angiography: younger and older cohorts (based on an age cutoff point of 35 years). Clinical and angiographic profiles were compared as primary endpoints, and in-hospital and 3-month major adverse cardiovascular events (MACE) were compared between the 2 cohorts as secondary endpoints.
Results: Each cohort was composed of 103 patients. The younger cohort, compared with the older cohort, revealed higher overweight (69.9% vs 51.5%), positive family history (12.6% vs 4.9%; P=0.048), use of gutka (smokeless tobacco) (56.3% vs 14.3%; P=0.017), smoking (41.7% vs 33%; P=0.195), total cholesterol (155.05±46.6 mg/dL vs 140.40±35.6 mg/dL; P=0.012), low-density lipoprotein cholesterol (96.74±41.23 mg/dL vs 84.14±27.25 mg/dL; P=0.010), normal/nonobstructive coronaries (15.5% vs 1.9%; P<0.001), single-vessel disease (60.2% vs 35.0%), type A lesions (36.8% vs 17.8%), left ventricular ejection fraction exceeding 40% (57.3% vs 42.7%; P=0.037), medical treatment only as the management strategy (16.5% vs 2.9%), in-hospital MACE (8.7% vs 12.6%; P=0.0367), and 3-month MACE (4.9% vs 12.6%; P=0.048), respectively.
Conclusions: Our younger subjects tended to have higher weight, gutka use, and positive family history than traditional risk factors with a greater frequency of single-vessel disease with type A lesions and normal or nonobstructive disease amenable to medical treatment only. (Iranian Heart Journal 2022; 23(2): 96-105)