The relative impact of smoking or Hypertension on severity of premature coronary artery disease

Background: Not much information is available about the effect of smoking and hypertension on the number and severity of vessel involvement and left ventricular ejection fraction (LVEF) at coronary angiography of young patients with coronary artery disease. The present study describes the relative importance and comparative effect of smoking and hypertension on severity of premature coronary artery disease. Methods: The study comprised 240 consecutive patients under the age of 45 years, with a diagnosis of acute myocardial infarction (AMI), unstable angina or stable angina, who underwent coronary angiography. Other aspects investigated included evaluation of smoking profile and HTN in each patient, LVEF, the number and type of vessel involvement as well as the severity of stenosis. Results: Of 216 patients, 142 (approximately 60%) were smoker and 74 (31%) were hypertensive. Left anterior descending coronary artery (LAD) involvement was more common in smoker young patients who had more severe stenosis of LAD vessel and lower LVEF than hypertensive young subjects. Higher frequency of right coronary artery (RCA) involvement and more severe stenosis of this vessel were found in hypertensive young individuals compared to smoker young patients. Conclusion: Our study indicated that smoking was more prevalent and also a more important risk factor in coronary artery disease of young adults. Smoker young patients tended to have more LAD involvement, more severe stenosis of this vessel and also lower LVEF, compared to hypertensive young patients