Study of lipid profile in young patients (age 40 years or below) with acute coronary syndrome

Abstract

Background: Acute coronary syndrome (ACS) refers to a group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina, non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction. Aims and Objectives: To study the incidence of lipid profile abnormalities in young patients (age 40 years or below) with ACS with clinical and cardiovascular risk profile. Material and Methods: The study was conducted on 223 young patients of acute coronary syndrome with age 40 years or below. 89 young patients with acute coronary syndrome having lipid abnormalities were further followed up after 1 month. Results: Majority of patients (55.15%) in the study population belonged to 35–40 years age group. Mean age of study population was 35.65 + 4.62 years with 90.13% males and 9.86% females. Main presenting symptom was precordial chest pain in 93.72% patients. Smoking was the commonest risk factor in young adults (81.7%). Other risk factors like diabetes, hypertension, family history were less common in young adults. Drug addiction was also higher in younger population (16%). Majority of young adults with acute coronary syndrome had more than 1 (47.53%) risk factor. Majority of patients were in Killip class I (86.9%) and only few patients (13.1%) had Killip class II or above. ST elevation myocardial infarction was far more common than NTEMI/USA and was found in 164 (73.5%) patients. Most common type of infarction was anterior wall myocardial infarction (62.80%). Majority of young patients had negative TMT, so it suggests that ACS in younger population has lesser complications during presentation, hospital stay and on follow-up. Conclusion: ACS in young continues to increase in Indian subcontinent. Younger patient with an ACS have different clinical characteristics and a different prognosis than older patients. The extent of CAD and degree of myocardial necrosis has influence on presentation and subsequent MACE in ACS and in this study, it appears dyslipidemia do not play any significant role in influencing extent of CAD and has little effect on outcome whether during acute stage or on immediate follow-up after ACS.

Unveiling the Influence of Smoking and Uncontrolled Lipid Profile in the Development of ST-Elevation Myocardial Infarction

“…In these studies, only 12% of young patients with STEMI had angina pectoris before the event, significantly lower than the percentage observed in older patients [ 4 , 6 ]. STEMI in young patients typically lacks ischemic preconditioning and develops and progresses more rapidly than in older patients [ 7 ]. This highlights the increased importance of pre-screening due to the high risk of unpredictable and severe events in this population.…”

“…To effectively prevent AMI in young patients, the primary focus should be on assisting them in quitting smoking. Cigarette smoking is widely recognized as a significant risk factor for the development of CAD in this age group [ 6 , 7 ]. Numerous studies have highlighted that a substantial proportion of young AMI patients are smokers, with rates ranging from 70% to 90%.…”

“…Comparatively, a significantly larger percentage of young AMI patients were current smokers when compared to those above 40 years old (37.5% vs. 23.0%; P < 0.001). Among young patients, there was also a higher incidence of STEMI (62.0% vs. 50.0%; P < 0.001) and a greater prevalence of non-significant narrowing in the coronary arteries (14.4% vs. 6.8%; P < 0.001) [ 7 ].…”

“…Recent studies concluded that a poor lipid profile, characterized by high LDL-C and triglyceride levels, is strongly associated with the development of STEMI in young individuals. Among young survivors of STEMI, high cholesterol levels were more commonly observed other than smoking cigarettes [ 7 , 8 ]. However, hypertension and diabetes were less prevalent in younger patients compared to older individuals [ 8 ].…”

“…The researchers also analyzed various risk factors associated with the correlation between diabetes and STEMI in young age. They found that poor glycemic control, prolonged duration of diabetes, and the presence of other cardiovascular risk factors such as hypertension and dyslipidemia further increased the likelihood of developing STEMI in diabetic individuals [ 7 , 8 ]. The result data above provide evidence for a strong correlation between diabetes mellitus and STEMI in young age.…”