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In the present study we aim to evaluate major predictors of premature coronary artery disease (PCAD) in patients aged ≤ 35 years undergoing coronary angiography for acute coronary syndrome.
We evaluated 224 consecutive patients aged ≤ 35 years who underwent coronary angiography at our institution between years 2003 to 2012. For each patient, demographics, coronary risk factors such as-family history of PCAD, hypercholesterolemia, diabetes mellitus, hypertension, cigarette smoking, cocaine use, biochemical profile and angiographic findings were recorded. Patients were divided into two group 1) significant CAD ≥ 50% stenosis and 2) No or Non-significant CAD. These two groups were compared and data was analyzed using SPSS 16.
Out of 224 patients, 64 had significant CAD and the remaining 160 had no or non-significant CAD. Prevalence of smoking was found to be significantly higher in the significant CAD group as compared to the no or non significant disease group [odds ratio = 5.06 with 95% confidence interval =1.64, 15.61, p=0.002]. Patients with significant CAD had an elevated White blood cell count (m place= 128.75) as compared to the patients in the no or non significant disease group (m place=97.87, U=3355.00, p=0.001) The significant CAD group also had higher random blood sugar (m place=131.48) as compared to the patients in the no or non significant disease group (m place=98.49, U=3287.50, p<0.001). In a subgroup of patient with myocardial infarction, the odds of having used cocaine was 4.92(CI=1.37, 17.71) times higher than the patients without myocardial infarction (χ2(df=1) =6.48, p=0.013). However, overall there was no difference in the prevalence of cocaine use in the significant CAD group as compared to the non-significant CAD (χ2 (df=1) =.292, p=0.059).
28.57% of patients under age < 35 years undergoing coronary angiography had significant CAD. PCAD was significantly associated with smoking, hyperglycemia, and leukocytosis. 3) Smoking continues to be an important and modifiable risk factor associated with PCAD. 4) Cocaine use in young patients is associated with higher incidence of myocardial infarction but is not a predictor of PCAD.