Angiographic patterns of coronary artery disease in young patients presenting at a tertiary cardiac center

Abdul Wajid Khan Faisal; Ghalib Habib; Samra Yasmin; Waqas Latif; Sheeraz Ahmed

doi:10.12669/pjms.38.8.6162

Angiographic patterns of coronary artery disease in young patients presenting at a tertiary cardiac center

Pak J Med Sci. 2022 Nov-Dec;38(8):2107-2111. doi: 10.12669/pjms.38.8.6162.

Authors

Abdul Wajid Khan Faisal¹, Ghalib Habib², Samra Yasmin³, Waqas Latif⁴, Sheeraz Ahmed⁵

Affiliations

¹ Abdul Wajid Khan Faisal, FCPS (Medicine); FCPS (Cardiology). Professor of Cardiology, Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan.
² Ghalib Habib, FCPS (Cardiology). Senior Registrar Cardiology, Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan.
³ Samra Yasmin, FCPS (Medicine); FCPS (Cardiology) Assistant Professor of Cardiology, Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan.
⁴ Waqas Latif, MSc. Biostatistics (PU), M. Phil. Statistics (UOS) Biostatistician, University of Health Sciences, Lahore, Pakistan.
⁵ Sheeraz Ahmed, BCS. IT Professional, Punjab Institute of Cardiology, Lahore, Pakistan.

Abstract

Objective: To compare the patterns of coronary artery disease (CAD) between young adults ≤35 years of age and patients >35 years of age.

Methods: The observational retrospective study was carried out in angiography department of emergency at Punjab Institute of Cardiology, Lahore between January 2020 and October 2020. Patients ≤35 years old were in Group-I whereas patients >35 years who served as controls were in Group-II. Patients with unstable angina, non-ST and ST elevation MI all were included. The patients with previous history of CAD (CABG/PCI) and angiography done for other purposes i.e., before valvular surgery or PPM implantation were excluded.

Results: Out of 1268 patients, 552 were in Group-I and 716 were in Group-II. The prevalence of normal coronaries/ mild CAD was higher in Group-I i.e., 224(40.6%) than in Group-II i.e., 64 (8.9%). Single vessel disease (SVD) was comparable in both the groups 185 (33.5%) vs. 216 (30.2%). Double vessel disease and triple vessel disease (TVD) was common in Group-II and left main stem (LMS) involvement was also significantly higher in Group-II i.e., 32 (4.5%) vs. 8 (1.4%). Clot in coronary arteries with or without underlying CAD was seen more frequently in Group-I, 61(11.1%) vs. 34 (4.7%). Presence of clot was seen mostly in those patients who had moderate coronary artery disease.

Conclusion: Young patients have different coronary artery disease patterns, so the management strategy must be different in this population. Majority of the young patients have non severe disease. Clot formation is commonly seen in young adults with moderate CAD.

Keywords: Angiographic patterns; Coronary artery disease; Young age.