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Coronary Artery Disease in Young: A Study of Risk Factors and Angiographic Characterization in the Valley of Kashmir

Ischemic heart disease is uncommon in young adults and may have some characteristics that are different from those in older patients. This study examined the risk factors for coronary artery disease and angiographic characterization in young adults. In current study 45 patients (90%) were men and only 5(10%) women. 10% of this population were obese and 78% were overweight. Risk factor analysis revealed smoking to be present in 78% of population. Family history was present in 52% of population. As compared to Diabetes Mellitus 12%, hypertension was present in 40% of patients and hyperlipidemia was seen in 48% of patients. Angiographically the percentage of coronaries involved was 84% (n=42). Nevertheless single vessel disease was the most common angiographic finding in the study group, 67% of patients had single vessel disease and 28% had double vessel while as about 5% patients had triple vessel disease. The left anterior descending artery was the most common artery involved followed by right coronary artery and circumflex artery. From these results we conclude that Myocardial infarction before age 45 is a disease of men. A sizeable proportion of patients will have normal coronary arteries. Coronary arteriography should be considered for patients who sustain a myocardial infarction before age 45 for purposes of diagnosis, management and prognosis. patients with IHD. However approximately half have single vessel atherosclerotic disease. The remainder have multi-vessel disease. The prevalence of left main coronary artery stenosis is approximately 5%. Multi-vessel disease is more likely in patients with multiple risk factors and diabetes. All young patients presenting with symptoms suggestive of IHD should be questioned of cocaine use 5 . Younger patients with IHD who undergo diagnostic catheterization are much more likely to have a major change in management than are older patients. Cigarette smoking appears to be the most common risk factor in young patients. The extent of smoking appears to be inversely related to the age at which IHD occurs 6 . The other significant risk factors in this age group include deranged lipid profile, positive family history, obesity, hypercoagulable states, coronary anomalies, diabetes mellitus, and oral contraceptive use in young woman. Other unusual causes include hypertension, vasulitic disorders, coronary aneurysms, mediastinal irradiations, valvular abnormalities, infective endocarditis 7-9