Year : 2020 | Volume
: 152 | Issue : 3 | Page : 263--272
Clinical profile & long-term natural history of symptomatic coronary artery disease in young patients (<30 yr)
Arun Gopalakrishnan, Harikrishnan Sivadasanpillai, Sanjay Ganapathi, Krishna Kumar Mohanan Nair, Sivasankaran Sivasubramonian, Ajitkumar Valaparambil
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, Kerala, India
Background & objectives: Several studies have shown a high prevalence of cardiovascular risk factors in patients in the age group of 30-74 yr, but there is a paucity of data in young patients below 30 yr. We analyzed the clinical and coronary angiographic profile of patients <30 yr of age with symptomatic coronary artery disease (CAD) and also assessed their intermediate and long-term outcomes.
Methods: All patients less than 30 yr of age who presented with symptomatic CAD from 1978 to 2017 in the department of Cardiology of a tertiary care hospital in south India, were studied for coronary risk factors and angiographic and treatment patterns, and the follow up data were collected.
Results: The mean age of the 159 patients <30 yr of age was 26.7±3.29 yr. Male preponderance was observed (91.8%), 63.5 per cent patients were smokers and 88.3 per cent were dyslipidaemic. Acute myocardial infarction was the most common mode of presentation. Forty one per cent patients were non-adherent to medications. Risk factor control was inadequate with respect to smoking cessation, alcoholism, physical activity and dietary regulation. The predictors of long-term mortality were multivessel CAD [hazard ratio (HR): 1.927, 95% confidence interval (CI): 1.003-3.701] and reduction in ejection fraction (EF) (10% decrease in EF; HR: 1.349, 95% CI: 1.096-1.662). Overall mortality was 30 per cent at 10 yr and 48 per cent at 20 yr.
Interpretation & conclusions: Decreasing EF and multivessel involvement were found to be the strong correlates for long-term mortality in young patients below 30 yr of age with CAD. High long-term mortality rates and poor risk factor control suggest the vast scope for the improvement of outcomes in these patients with aggressive risk factor control.
Dr Harikrishnan Sivadasanpillai
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram 695 011, Kerala
|How to cite this article:|
Gopalakrishnan A, Sivadasanpillai H, Ganapathi S, Mohanan Nair KK, Sivasubramonian S, Valaparambil A. Clinical profile & long-term natural history of symptomatic coronary artery disease in young patients (<30 yr).Indian J Med Res 2020;152:263-272
|How to cite this URL:|
Gopalakrishnan A, Sivadasanpillai H, Ganapathi S, Mohanan Nair KK, Sivasubramonian S, Valaparambil A. Clinical profile & long-term natural history of symptomatic coronary artery disease in young patients (<30 yr). Indian J Med Res [serial online] 2020 [cited 2020 Nov 24 ];152:263-272
Available from: https://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=152;issue=3;spage=263;epage=272;aulast=Gopalakrishnan;type=0