PREDICTORS OF MULTIVESSEL CORONARY ARTERY DISEASE IN YOUNG PATIENTS PRESENTING WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Ayaz Mir,Ali Ammar,Atif Sher Muhammad,Tahir Saghir,Syed Zia Ullah,Javaid Ur Rehman,Faiza Farooq

doi:10.47144/phj.v54i3.2168

Abstract

Objectives: Premature coronary artery disease (CAD) is on the rise in our population, and multivessel disease (MVD) is no longer an uncommon finding in young patients. Therefore, aim of this study was to determine the predictors of MVD in young patients who presented with ST-Segment Elevation Myocardial Infarction (STEMI). Methodology: For this study, we enrolled 294 young adult (18-40 years) patients with STEMI. MVD was diagnosed based on angiography. Demographic characteristics and baseline risk profiles were considered for the univariate and multivariate analyses to determine the predictors of MVD. Results: Out of 294 patients, 90.5% (266) were males, and the mean age was 35.45 ± 4.07 years. Our 24.1% (71) patients were hypertensive (HTN), and 36.1% (106) were smokers. A total of 94 patients had MVD. Patients with MVD were older and more likely to have diabetes (DM) and HTN than their counterparts. Only age and DM were found to be significant independent predictors of MVD. The risk of developing MVD was higher in diabetics, with adjusted odds ratios (ORs) [95% CI] of 2.47 [1.23-4.97; p=0.011]. Conclusion: In conclusion, we showed that age and DM are independent predictors of MVD in a young Pakistani adult population presenting with STEMI. However, none of the other risk factors, such as obesity, male gender or smoking, were found to be significantly associated with MVD in Pakistani adults with premature CAD. Although significantly associated, HTN does not prove to be an independent predictor of multivessel CAD in young adults.

Highlights

Acute myocardial infarction (AMI) remains the most fatal manifestation of coronary artery disease and may lead to sudden cardiac death
Risk factors for ACS in young adults have been studied in detail, risk factors for multivessel coronary artery disease (CAD) in young adults have not been explored in our country
This study aimed to identify predictors of multivessel disease (MVD) in Pakistani adults presenting with premature CAD

Summary

Introduction

Acute myocardial infarction (AMI) remains the most fatal manifestation of coronary artery disease and may lead to sudden cardiac death. AMI in young individuals has a relatively better prognosis,[9,10,11] its social and economic burden is critical for both family and society during the productive years of life.[12] Its clinical presentation, disease anatomy and risk profile are dissimilar compared to those of older individuals.[1] Some studies have reported that premature MI is more likely associated with smoking, male gender, dyslipidemia and positive family history and is less associated with diabetes mellitus (DM) and hypertension (HTN).[1,6]

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