Risk Factors and Angiographic Profile in Young Individuals with Acute ST-Elevation Myocardial Infarction (STEMI)

Abstract

Coronary artery disease (CAD) represents the leading cause of death in adults and Myocardial infarction (MI) is the lethal manifestation of that. Although males and females beyond certain age are prone to CAD, young men and/or women also suffer from MI. Apart from the rare case reports of non-athermatous coronary artery disease including hyper-coagulable states, spontaneous dissections and/or substance abuse in young MI, the prevalence of conventional risk factors are on rise in young adults and children. The protection offered by young age has been overshadowed by the increased prevalence of these risk factors. To evaluate the prevalence of such conventional risk factors and angiographic pattern in young MI, we did an observational, retrospective study at our tertiary care center. It was observed that one-fourth of young MI had no conventional risk factors and among the rest, obesity (48%) was most common, followed by diabetes mellitus (DM) (32%), Hypertension (29.5%), smoking (15.5%), alcoholism (11%), and a family history of premature CAD (3%). Among the participants, 35.5%, 22.5%, 12%, 4%, and 1% of patients had one, two, three, four, and five risk factors, respectively. On angiography, Left Anterior Descending (LAD) was the most commonly diseased coronary artery (77%) followed by Right Coronary Artery (RCA) (30.5%) and Left Circumflex (LCx) (29.5%). Single-vessel disease (SVD) (69.5%) was the most frequent observation on CAG, whereas 24% and 6.5% of patients had double-vessel and triple-vessel disease (DVD, TVD), respectively.