Abstract
Coronary artery disease (CAD) is a major public health problem which in turn imposes a significant burden on health care systems because of high morbidity and mortality. Although the multifactorial etiology of CAD increases with age, but in recent years, the incidence is increasing among younger age groups. In this study we aimed to evaluate the effect of age on risk profile, inflammatory response and the angiographic findings in patients with ACS. The study comprised 253 ACS patients. Seventy six (30%) with UA, 56 (22%) with NSTEMI and 121(48%) with STEMI diagnosis. The value of Hs-CRP, lipid profile, cardiac enzymes, risk factors, EF% and angiographic score were analyzed and compared in different age groups. Group 1 (n = 68) with age <45 years, group II (n = 110) with age >/=45-<65 years and group III (n = 75) >/=65 years. Group I had more prevalence of male sex, smoking, family history, hypertriglyceridemia and low levels of HDL (P < 0.01), higher incidence of STEMI (P < 0.01) and lower prevalence of UA (P < 0.01). Diabetes mellitus, hypertension, and female gender were more common in older groups. Hs-CRP was significantly lower in the young age (group I). Group I showed a preponderance of single-vessel disease, lower coronary atherosclerotic score and prevalent left anterior descending artery (LAD) involvement compared with older age groups. Hs-CRP was positively correlated to severity of CAD only in older groups. Stepwise multiple regression analysis showed that age, male gender, cardiac enzymes and EF% were common predictors of multivessel disease. Smoking was independent predictor in young patients <45 years while diabetes and Hs-CRP was the key predictor in older patient groups. Young patients with ACS had different clinical, angiographic and biochemical profile. Hs-CRP peak concentration did not correlate with angiographic findings in young patients that could be attributed to different risk profile and discrete underlying mechanism.
Highlights
Acute coronary syndromes (ACS) are a major health problem and account for a large proportion of the total number of hospitalizations all over the world.[1]
high sensitivity C reactive protein (Hs-C-reactive protein (CRP)) peak concentration did not correlate with angiographic findings in young patients that could be attributed to different risk profile and discrete underlying mechanism
To examine the relationship of age to risk profile, Hs-CRP and the severity of Coronary artery disease (CAD) in patients with ACS, patients was classified according to their age into 3 groups:
Summary
Acute coronary syndromes (ACS) are a major health problem and account for a large proportion of the total number of hospitalizations all over the world.[1] There is a general agreement on a multifactorial etiology of coronary artery disease (CAD) and that the incidence of disease increases with age.[2] it has been recognized in young age groups more frequently in recent years.[3,4] Worldwide, about 4% of patients with myocardial infarction (MI) are younger than 40 years of age.[5] These patients frequently have characteristics that are different from those seen in older patients. The multifactorial etiology of CAD increases with age, but in recent years, the incidence is increasing among younger age groups
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