Abdul Wajid Khan Faisal, Mohammad Ayub, Tariq Waseem, Rao Shahzad Abdul Tawwab Khan, Syed Sibitul Hasnain


Background: Ischemic heart disease is a leading cause of death throughout the world. CAD has been
recognized among younger age group more frequently in recent years. Very limited data is available
regarding the prevalence of various risk factors in our younger patients that is why this study was
planed. Objectives of the study were to look for the risk factors most prevalent in our young patient of
1st Acute Myocardial Infarction. And to also look for the number of Risk Factors present in each
patient. Methods: We studied 100 consecutive patients from 16–45 years of age presenting with first
acute MI. Twelve risk factors were studied namely, gender, family history of premature CAD, smoking
hypertension, diabetes, dyslipidemia, obesity, mental stress (type A personality), alcohol, oral
contraceptive pills (OCPs), physical activity, and diet. We divided the patients into two groups. Group
A with patients 35 years of age or less and group B with patients 36–45 years of age. All risk factors
were compared in both the groups. Results: Smoking, diabetes mellitus, dyslipidemia and hypertension
were statistically different between the two groups. Frequency wise risk factors were lined up as male
sex (91%) Diet (66%), Dyslipidemia (62%), smoking (46%), Type A personality(46%), family history
(32%), diabetes mellitus (28%), sedentary lifestyle (26%), hypertension (22%), obesity (17%), alcohol
(3%), and OCPs (0%) Most of the patients that is 94% had 3 or more risk factors. Conclusion:
Smoking, hypertension, diabetes and dyslipidemia are the major modifiable risk factors in our young
adults. If a young male who is smoker or a young female who is diabetic, presents in emergency room
with chest pain, always suspect coronary artery disease. Other conventional risk factors are also
prevalent but alcohol and OCPs are not a major health problem for us.
Keywords: Risk factors, young patients, acute myocardial infarction

Full Text:



Murray CJ, Lopez AD. Mortality by cause for eight regions of

the world: Global Burden of Disease Study. Lancet


Enas EA, Senthilkumar A. Coronary Artery Disease In Asian

Indians: An Update And Review. Int J Cardiol 2002;1(2):1–34.

McGill HC Jr, McMaham CA, Zieske AW, Tracy RE, Malcom

GT, Herderick EE, et al. Association of Coronary Heart Disease

Risk Factors With Microscopic Qualities of Coronary

Atherosclerosis in Youth. Circulation 2000;102:374–9.

Ford ES, Capewell S. Coronary Heart Disease Mortality Among

Young Adults in the US. From 1980 through 2002. J Am Coll

Cardiol 2007;50:2128–32.

Ford ES, Mokdad AH, Giles WH. Trends in waist circumference

among US adults. Obes Res 2003;11:1223–31.

Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the

metabolic syndrome among US adults. Diabetes Care


Ford ES, Mokdad AH, Giles WH, Mensah GA. Serum total

cholesterol concentrations and awareness, treatment, and control

of hypercholesterolemia among US adults: findings from the

National Health and Nutrition Examination Survey, 1999–2000.

Circulation 2003;107:2185–9.

Carroll MD, Lacher DA, Sorlie PD, Cleeman JI, Gordon DJ,

Wolz M, et al. Trends in serum lipids and lipoproteins of adults,

–2002. JAMA 2005;294:1773–81.

Hajjar I, Kotchen TA. Trends in prevalence, awareness,

treatment, and control of hypertension in the United States,

–2000. JAMA 2003;290:199–206.

Centers for Disease Control and Prevention. Prevalence of

Diabetes and impaired fasting glucose in adults- United States,

–2000. MMWR Morb Mortyl Wkly Rep 2003;52:833–7.

Ahmed S, Yaqoob Z, Samad A. Acute myocardial infarction in

an 18 years old Pakistani girl without classical risk factors for

premature coronary artery disease (case report). Pak J Cardiol


Llyod-Jones DM, Larson MG, Beiser A, Levy D. Lifetime risk of

developing coronary artery disease. Lancet 1999;353:89–92.

Akhtar J, Islam N, Khan J, Risk factors and outcome of ischemic

heart disease in young Pakistani adults. Specialist 1993;9:123–6.

Hennekens CH. Coronary disease: risk intervention. In: Julian

DG, Wenger NK, (editors), Women and heart disease, 1st ed.,

London: Martin Dunitz; 1997. p. 39–48.

Cullen P, Schulte H, Assmann G. Smoking, lipoproteins and

coronary heart disease risk. Data from the Munster Heart Study

(PROCAM). Eur Heart J 1998;19:1632–41.

Sugiishi M, Takatsu F. Cigarette smoking is a major risk factor

for coronary artery spasm. Circulation1993;87:76–9.

Kato I, Toniolo P, Akhmedkhanov A, Koenig KL, Shore R,

Zeleniuch-Jacquotte A. Prospective study of factors influencing the

onset of natural menopause. J Clin Epidemiol 1998;51:1271–6.

Hu FB, Grodstein F, Hennekens CH, Colditz GA, Johnson M,

Manson JE, et al. Age at natural menopause and risk of

cardiovascular disease. Arch Intern Med 1999;159:1061–6.

Pais P, Pogu J, Gerstein H, Zachariah E, Savitha D, Jayprakash S,

et al. Risk factors for acute myocardial infarction in Indians: A

case control study. Lancet 1996;348:358–63.

Gandapur ASK, Yar S, Majid T. Study of risk factors in coronary

heart disease. Pak Heart J 1998;21:89–91.

Mckeigue PM, Ferrie JE, Pierpoint T, Marmot MG. Association

of early onset heart disease in South Asian men with glucose

intolerance and hyperinsulinemia. Circulation 1993;87:152–61.

Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B,

Speizer FE, et al. Weight, weight change, and coronary heart

disease in women. Risk within the ‘normal’ weight range. J Am

Med Assoc1995;273:461–5.

Van Gaal LF, Wauters MA, De Leeuw IH. The beneficial effects

of modest weight loss on cardiovascular risk factors. Int J Obes

Relat Metab Disord 1997;21(Suppl 1):S5–S9.

Berlin JA, Golditz GA. A meta analysis of physical activity in the

prevention of coronary heart disease. Am J Epidemiol


Thomas I, Gupta S, Sempson S, Cooper R. Serum lipids in

Indian Physicians in the US compared to US born physicians.



  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]