Acute Cardiac Ischemia in Young Adults: Characteristics and Risk Factors

ABSTRACT

PURPOSE: Acute cardiac ischemia under the age of 45 years is uncommon. This study was to evaluate the prevalence of various risk factors, the angiographic characteristics, and the prognosis in young patients with acute cardiac ischemia compared with that in older patients. METHODS: A review was retrospectively done of 554 patients with acute cardiac ischemia from January 2002 to December 2002. The patients were divided into two groups patients under 45 years old (75 patients) and patients over 45 years old (479 patients). The clinical features which were compared between the two groups were demographic features, risk factors (cigarette smoking, history of hypertension and diabetes, hypercholesterolemia, hypertriglyceridemia, and family history of ischemic cardiac disease), coronary angiographic findings, and prognosis. RESULTS: The incidence of acute cardiac ischemia in patients under 45 years old was 13.5% (75/554). Three clinical risk factors, a history of cigarette smoking, a positive family history coronary artery disease, and hypertriglyceridemia, were significantly more prevalent in the young patients. Angiographically, normal or minimal coronary obstructions were more frequently found in the young patients, and significant coronary obstructions were more frequently found in the older patients. However the incidences of single-vessel disease and multi-vessel disease between young patients and older patients were not different. Young patients with acute cardiac ischemia do not have a more favorable prognosis than older patients. CONCLUSION: Acute cardiac ischemia is found in young patients with less extensive disease, but young patients do not have a more favorable prognosis than older patients.