PATTERN OF CORONARY ARTERY DISEASE WITH NO RISK FACTORS UNDER AGE 35 YEARS
AbstractBackground: Coronary artery disease (CAD) is no more deemed to be an ailment of the 4th or5th decade; rather an earlier age incidence is not infrequently encountered in our population.However, there are a few data regarding CAD in young adults, and much about its underlyingpathology still remains undetermined. The objective of this study was to delineate the coronaryarterial disease pattern in adults under the age of 35 years, but having no known coronary riskfactors. Methods: This prospective study was conducted at the Cardiology Departments of all 3public sector tertiary care hospitals in Peshawar from Jun 2008 to Dec 2009. After havingexcluded the traditional risk factors for CAD, patients under the age of 35 years with objectiveevidence of CAD were subjected to percutaneous coronary angiography. Results: Out of a totalof 104 patients, 85 (81.73%) patients were men, and 19 (18.27%) were women. The mean ageof the whole group was 32.66±3.237 (22–35) years. Significant CAD (>50% diameternarrowing of at least one major coronary artery) was found in 87 (83.7%) patients while 17(16.3%) patients had non-atherosclerotic coronary artery disease, including 12 (11.53%) patientshaving normal coronary arteries, 1 (1%) patient had anomalous origin of right coronary artery(RCA), 1 (1%) patient had coronary arteritis, 2 (1.92%) patients had coronary artery ectasia, and1 (1%) patient had a myocardial bridge over left anterior descending artery (LAD). Among thepatients with significant CAD, the prevalence rate of one, two and three vessel disease was 54(51.9%), 22 (21.2%) and 11 (10.6%) respectively. Almost 50% of the lesions occurred in LADfollowed by 25% in RCA and 20% in circumflex, while only one patient (1%) had isolatedsignificant CAD of left main coronary artery. Osteal segments were involved in 10%, proximalin 61%, mid in 21% and distal segments in 7% of the lesions. Conclusion: In the younger agegroup, CAD is mostly a disease of men, single vessel CAD predominates with LADinvolvement mostly, predominant osteal to proximal segment involvement of vessels, and amuch higher incidence of normal coronaries and non-obstructive CAD is met with.Keywords: Coronary Artery Disease (CAD), Myocardial infarction (MI), CoronaryAngiography, Risk Factors
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