CHARACTERISTICS OF THE CORONARY ARTERIAL LESIONS IN YOUNG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

ABSTRACT OBJECTIVES: To assess characteristics of coronary arterial lesion (CAL) by means of invasive coronary angiography in young patients, aged <35 years, who sustained acute myocardial infarction (AMI).METHODS: This prospective study of one-year duration was conducted from December 2009 to November 2010 at the cardiology departments of three teaching hospitals in Peshawar, Pakistan. All patients aged <35 years, evaluated angiographically after an AMI, were included. The individual CAL were characterized.RESULTS: About 101 patients with AMI underwent coronary angiography. Mean age of the patients was 32.56±3.26 years (range 22–35 years). Out of 101 patients, 86 (78.18%) were males, while 15 (21.81%) were females. On coronary angiography, there were 25 (24.8%) patients with non-atherosclerotic coronary arteries, 39 (38.6%) with single vessel disease (SVD), 18 (17.8%) had double vessel disease (DVD), and 19 (18.8%) had triple vessel disease (TVD). Of the total, 3 patients (2.97%) had disease in the left main stem. One hundred thirty-two lesions (39x1=39 in SVD; 18x2=36 in DVD & 19x3=57 in TVD) were studied. The lesions were mostly discrete to tubular with less diffuse involvement and had either no or mild calcification. Thrombus was found in 5 patients with SVD (12.82%), 2 with DVD (11.11%) and 1 with TVD (1.75%).CONCLUSION: This study shows that young (age <35 years) patients who have sustained AMI, have less extensive coronary artery disease but complex morphologic features. There was a higher incidence of normal vessels on coronary angiography with a very few cases of left main coronary arterial involvement.KEY WORDS: Myocardial Infarction (MeSH); Coronary Artery Disease (MeSH); Coronary arterial lesions (Non-MeSH); Coronary Angiography (MeSH), Atherosclerosis (MeSH)