CHARACTERISTICS OF THE CORONARY ARTERIAL LESIONS IN YOUNG PATIENTS (< 35YEARS) WITH ACUTE MYOCARDIAL INFARCTION
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Abstract
Objective: This study was designed to assess characteristics of coronary arteriallesion by means of invasive coronary angiography in young patients, less than age35 years, who sustained acute myocardial infarction.
Methodology: This prospective study was conducted from December 2009 toNovember 2010 at the cardiology departments of all the three tertiary care hospitalsin Peshawar. Total duration of the study was one year. All patients aged <35 yearswho were evaluated angiographically after an acute myocardial infarction wereincluded. The individual coronary arterial lesions were characterized.
Result: A total of 101 patients with acute myocardial infarction underwentcoronary angiography. Mean age of the patients was 32.56±3.26 years (range 22- 35 years). About eighty-six patients (78.18%) were males. As revealed by thecoronary angiography, there were 25 (24.8%) patients with non-atheroscleroticcoronary arteries, 39 (38.6%) with single vessel disease, 18 patients (17.8%) haddouble vessel disease, and 19 patients (18.8%) had triple vessel disease.Of thetotal, 3 patients (2.97%) had disease in the left main stem. As far as the length of thelesions is concerned, the lesions were mostly discrete to tubular with less diffuseinvolvement.The lesions mostly either had no or mild calcification. Thrombus wasfound in 5 patients with SVD (12.82%), 2 patients with DVD (11.11%) and 1 patientwith TVD(1.75%).These lesions were located mostly in the ostial to proximalsegments, and were mostly severely to completely occlusive disease. Type Alesions were found in 14%, type B1 in 33%, type B2 in 27%, type C1 in 25%, andtype C2 in none.
Conclusion: We found that young (age < 35 years) patients who havemyocardial infarction, have less extensive coronary artery disease but complexmorphologic features, with a high incidence of angiographically normal vessels andrelative paucity of left main coronary arterial involvement.