Association of Co-Morbidity and Treatment with the Complications of Acute Coronary Syndrome in Young Patients Less Than 45 Years.

Abstract

Approximately 5%-10% of acute coronary syndrome (ACS) cases occur in people younger than 45 years of age. This study aimed to identify complications of ACS and the associated factors in young patients. In this cross-sectional study, data from 147 ACS patients aged less than 45 years were analysed. The mean age was 39.1 (4.9) years, the male to female ratio was 3:1; 21.2% of patients presented with unstable angina, 58.5% had non-ST elevation myocardial infarction and 20.4% had ST elevation myocardial infarction. The most frequent risk factor of ACS was dyslipidaemia (65.3%), followed by hypertension (43.5%). In total, 49.7% of patients had inpatient complication(s), with the most common being heart failure (35.4%), followed by arrhythmia (20.4%). The significant factors associated with ACS complications were current smoking [adjusted odds ratio (AOR) 4.03; 95% confidence interval (CI): 1.33, 12.23; P-value = 0.014], diabetic mellitus [AOR 3.03; 95% CI: 1.19, 7.71; P-value = 0.020], treatments of fondaparinux [AOR 0.18; 95% CI: 0.08, 0.39; P-value < 0.001] and oral nitrates [AOR 0.18; 95% CI: 0.08, 0.42; P-value < 0.001]. Smoking status and diabetes mellitus were modifiable risk factors while pharmacological treatment was an important protective factor for ACS complications in young patients.