Risk factor analysis and angiographic findings in young myocardial infarction patients in tertiary care centre of rural population in South India

J.M. Ravichandran Edwin, E. Thirulogachandar, Heber Anandan


Background: Coronary Artery Disease (CAD) is the leading cause of death and accounts for around 12million deaths annually worldwide. The pattern of coronary artery involvement and clinical outcome varies with age suggesting different underlying pathophysiology. Better understanding this specific problem will lead to further improvement in management. The aim was to study the risk factors and angiographic findings in young patients with acute myocardial infarction.

Methods: Thirty-nine patients were included in this study. Patients included in the study underwent elective angiographic performed by the percutaneous femoral approach using standard angiographic techniques. Echo and lipid profile were done to all patients. Data were analysed using MS-Excel.

Results: In this study, 39 patients were included, 37 male and 2 female patients, the average age of the patients was 35.12 years. 59% of patients had hypertriglyceridemia, 23.1% of patients hypercholesteremia. 45.9% of male patients were having a history of smoking and alcoholism. 84.6% of patients had obstructive CAD, single vessel disease was observed in 59%, double vessel disease in 7.7%, triple vessel in 2.6% patients.

Conclusions: Acute myocardial infarction in young predominantly affects males. Dyslipidemia, smoking and alcoholism were found to be common associated factors in young MI. This emphasizes the need for lifestyle modification for primary prevention. Coronary angiography revealed normal coronaries in 12% suggesting different underlying process other than atherosclerosis. With timely intervention and appropriate management, prognosis is good in young MI patients.


Coronary angiography, Risk factors, Young male

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Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366(9498):1744-9.

Institute of Health Metrics and Evaluation. GBD Compare, 2010. Available at: Accessed 30 April 2018.

Zimmerman FH, Cameron A, Fisher LD, Grace NG. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (coronary artery surgery study registry). J Am Coll Cardiol. 1995;26(3):654-61.

Pineda J, Marín F, Roldán V, Valencia J, Marco P, Sogorb F. Premature myocardial infarction: clinical profile and angiographic findings. Inter J Cardiol. 2008;126(1):127-9.

Klein LW, Agarwal JB, Herlich MB, Leary TM, Helfant RH. Prognosis of symptomatic coronary artery disease in young adults aged 40years or less. Am J Cardiol. 1987;60(16):1269-72.

Giovino GA, Mirza SA, Samet JM, Gupta PC, Jarvis MJ, Bhala N, et al. Tobacco use in 3billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet. 2012;380(9842):668-79.

Lal PG, Wilson NC, Gupta PC. Attributable deaths from smoking in the last 100years in India. Current Sci. 2012:1085-90.

Enas EA, Yusuf S, Mehta J. Meeting of the international working group on coronary artery disease in South Asians. 24 March 1996, Orlando, Florida, USA. Ind Heart J. 1996;48(6):727.

Hoit BD, Gilpin EA, Henning H, Maisel AA, Dittrich H, Carlisle J, et al. Myocardial infarction in young patients: an analysis by age subsets. Circulation. 1986;74(4):712-21.

Burkart F, Salzmann C. Angiographic findings in post-infarction patients under the age of 35. In: Myocardial Infarction at Young Age. Springer; Berlin: Heidelberg; 1981:56-60.

Bajaj S, Shamoon F, Gupta N, Parikh R, Parikh N, DeBari VA, et al. Acute ST-segment elevation myocardial infarction in young adults: who is at risk?. Coronary Artery Dis. 2011;22(4):238-44.

Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, Borger MA, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Euro Heart J. 2012;33(20):2569-619.

Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Euro Heart J. 2011;32(23):2999-3054.

Holmes DR, White HD, Pieper KS, Ellis SG, Califf RM, Topol EJ. Effect of age on outcome with primary angioplasty versus thrombolysis. J Am Coll Cardiol. 1999;33(2):412-9.

Moccetti T, Malacrida R, Pasotti E, Sessa F, Genoni M, Barlera S, at al. Epidemiologic variables and outcome of 1972 young patients with acute myocardial infarction: data from the GISSI-2 database. Arch Inter Med. 1997;157(8):865-9.

Kofflard MJ, De Jaegere PP, Van Domburg R, Ruygrok P, Van den Brand M, Serruys PW, et al. Immediate and long-term clinical outcome of coronary angioplasty in patients aged 35years or less. Heart. 1995;73(1):82-6.