Uma Devi Karuru*, Naveen T, Sai Kumar Mysore, Sadanand Reddy Tummala, Paladugu Srinivas Gautam, Ashirbad Parhi and Kiran Kumar Kanjerla

Department of Cardiology, ESIC Medical College and Super Speciality Hospital, Hyderabad, Telangana, India

*Corresponding Author: Uma Devi Karuru, Assistant Professor, Department of Cardiology, ESIC Medical College and Super Speciality Hospital, Hyderabad, Telangana, India.

Received: February 13, 2025; Published: February 23, 2025

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, influenced by multiple risk factors, demographic variations, and lifestyle factors. Early identification and management of CAD are essential to reducing adverse cardiovascular events. This study aims to analyse CAD prevalence, clinical presentation, risk factor burden, electrocardio graphic (ECG) findings, and coronary involvement patterns in a hospital-based population, with an emphasis on gender-specific differences.

Materials and Methods: This retrospective study was conducted from January 2023 to August 2024 at a tertiary care hospital in South India, involving a cohort of 298 patients from a low socioeconomic background. The inclusion criteria encompassed all pa tients aged between 18-45 years admitted to the hospital with a diagnosis of ACS. Demographic data, clinical symptoms, ECG findings, and coronary angiographic patterns were assessed. Major cardiovascular risk factors, including smoking, hypertension, diabetes mellitus, dyslipidaemia, obesity, and family history, were evaluated. The severity of coronary artery involvement was classified into single-vessel disease (SVD), double-vessel disease (DVD), and triple-vessel disease (TVD). Data were stratified by gender to assess differences in disease presentation and severity.

Results: Males comprised 77.8% of cases, with the majority aged >41 years (57.4%). Chest pain (90%) was the most common symp tom, while women frequently presented with atypical symptoms such as dyspnoea and epigastric pain. STEMI (35.5%), NSTEMI (28.5%), and unstable angina (35.9%) were the predominant ECG findings. The left anterior descending artery (LAD) was the most affected vessel (48%), and single-vessel disease (SVD) was most common (48.6%). Key risk factors included smoking (81.2%), hy pertension (56.3%), dyslipidaemia (46.9%), diabetes (38.6%), and obesity (51.6%). Women had a lower incidence of multivessel disease but presented with more risk factors. Notably, smoking was significantly higher in males, reinforcing its role as a primary risk factor for CAD. Hypertension and diabetes were more frequent in patients with multivessel disease, suggesting their role in disease progression.

Conclusion: This study highlights the high prevalence of CAD in males, with LAD involvement and SVD being the most common findings. The significant burden of modifiable risk factors emphasizes the importance of early screening, lifestyle modifications, and aggressive medical management. Women often present with atypical symptoms, which may contribute to underdiagnosis and delays in treatment, necessitating gender-specific diagnostic approaches. The predominance of STEMI indicates late disease presentation, emphasizing the need for public awareness programs on early symptom recognition. Future multicentre, prospective studies with long-term follow-up and broader risk factor assessment are required to further investigate CAD progression and optimize prevention and treatment strategies

Keywords: Young Heart; Acute Coronary Syndrome; Young Population

References

1. Alkhawam H., et al. “Coronary Artery Disease in Young Adults”. The American Journal of the Medical Sciences 6 (2015): 479-483.
2. Andersson C and Vasan RS. “Epidemiology of cardiovascular disease in young individuals”. Nature Reviews Cardiology4 (2018): 230-240.
3. Aggarwal A., et al. “Newer perspectives of coronary artery disease in young”. World Journal of Cardiology12 (2016): 728-734.
4. Global Burden of Disease Study. “Global, regional, and national age-sex-specific mortality and burden of disease attributable to risk factors for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017”. Lancet10159 (2017): 1789-1858.
5. Bhardwaj R., et al. “Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement”. Nigerian Medical Journal1 (2013): 44-47.
6. Sinha SK., et al. “Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India-AMIYA Study”. ARYA Atheroscler2 (2017): 79-87.
7. Li Z., et al. “Clinical and coronary angiographic features of young women with acute myocardial infarction”. Zhonghua Xin Xue Guan Bing Za Zhi3 (2012): 225-230.
8. Liu W., et al. “Long-term follow up of percutaneous coronary intervention of coronary artery disease in women ≤45 years of age”. American Journal of Cardiology7 (2013): 918-922.
9. Suri P., et al. “Risk Factors and Angiographic Profile in Young Individuals with Acute ST-Elevation Myocardial Infarction (STEMI)”. Indian Journal of Clinical Cardiology4 (2023): 242-247.
10. Unger T., et al. “2020 International Society of Hypertension Global Hypertension Practice Guidelines”. Hypertension6 (2020): 1334-1357.
11. American Diabetes Association. “Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020”. Diabetes Care 43 (2020): S14-S31.
12. Adeloye D., et al. “Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis”. BMC Public Health 19 (2019): 1719.
13. Misra A., et al. “Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management”. Journal of the Association of Physicians of India 57 (2009): 163-170.
14. Knapper JT., et al. “Coronary calcium scoring for long-term mortality prediction in patients with and without a family history of coronary disease”. Heart 3 (2016): 204-208.
15. Yusuf S., et al. “Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study”. Lancet9438 (2004): 937-952.
16. Meyer MR and Barton M. “Estrogens and Coronary Artery Disease: New Clinical Perspectives”. Advances in Pharmacology 77 (2016): 307-360.
17. Aggarwal A., et al. “A retrospective case-control study of modifiable risk factors and cutaneous markers in Indian patients with young coronary artery disease”. JRSM Cardiovascular Disease3 (2012): cvd.2012.012010.
18. Cole JH., et al. “Long-term follow-up of coronary artery disease presenting in young adults”. Journal of the American College of Cardiology 4 (2003): 521-528.
19. Iribarren C., et al. “Association of hostility with coronary artery calcification in young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults”. JAMA19 (2000): 2546-2551.
20. Nadeem M., et al. “Risk factors for coronary heart disease in patients below 45 years of age”. Pakistan Journal of Medical Sciences1 (2013): 91-96.
21. Sekhri T., et al. “Prevalence of risk factors for coronary artery disease in an urban Indian population”. BMJ Open12 (2014): e005346.
22. Kumbhalkar Sunita Dinkar and Vikas V Bisne. "Clinical and angiographic profile of young patients with ischemic heart disease: A central India study”. Journal of Clinical and Preventive Cardiology1 (2019): 6-12.
23. Máchal J., et al. “Patients with chronic three-vessel disease in a 15-year follow-up study: genetic and non-genetic predictors of survival. Medicine (Baltimore)28 (2014): e278.

Citation

Citation: Uma Devi Karuru., et al. “The Young Heart Crisis: Exploring the Rising Burden of Acute Coronary Syndrome in the Young Population".Acta Scientific Paediatrics 8.2 (2025): 21-29.

Copyright

Copyright: © 2025 Uma Devi Karuru., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.