FREQUENCY OF RISK FACTORS IN PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME BELOW 40 YEARS OF AGE

Abstract

Objective: To determine the frequency of factors leading to acute coronarysyndrome in patients below 40 years of age presenting to tertiary care center.

Methodology: This descriptive cross sectional study was conducted at NationalInstitute of Cardiovascular Disease, Karachi from 20thAugust 2015 to 19February, 2016 for six months. Individuals of both genders with age below 40years presented with acute coronary syndrome for first time were included.Patients with valvular heart disease, congenital heart disease, Congestivecardiac failure, chronic renal and respiratory failure were excluded from the study.

Results: Total of 86 patients were included. The average age of the patients was35.80 ± 4.21 years (95%CI: 34.89 to 36.71). Out of 85 patients, 72 (85%) weremales and 13 (15%) were females with 5.54:1 male to female. ratio. ST-segmentelevation myocardial infarction (STEMI) was observed in 38 (44.7%) cases, non-ST-segment elevation myocardial infarction (NSTEMI) was seen in 20 (23.5%)cases and unstable angina (UA) was observed in 27 (31.8%) patients. Familyhistory was the commonest factor leading to acute coronary syndrome observedin 45 (52.9%) cases followed by smoking [31 (36.5%)], Obesity [14 (16.5%)].dyslipidemia [13 (15.3%)], diabetes mellitus [10 (11.8%)] and hypertensionobserved in [5 (5.9%)] cases. Smoking was commoner in higher age groups(p=0.013).Comparison of factors of acute coronary syndrome between maleand female revealed that smoking, family history, diabetes mellitus, hypertensionwere significantly higher in male patients than female.

Conclusion: Family history emerged as a most common risk factor associatedwith acute coronary syndrome in young individuals.