CHARACTERISTICS OF THE CORONARY ARTERIAL LESIONS IN YOUNG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

OBJECTIVES: To assess characteristics of coronary arterial lesion (CAL) by means of invasive coronary angiography in young patients, aged 35 years, who sustained acute myocardial infarction (AMI). METHODS: This prospective study of one-year duration was conducted from December 2009 to November 2010 at the cardiology departments of three teaching hospitals in Peshawar, Pakistan. All patients aged 35 years, evaluated angiographically after an AMI, were included. The individual CAL were characterized. RESULTS: About 101 patients with AMI underwent coronary angiography. Mean age of the patients was 32.56±3.26 years (range 22-35 years). Out of 101 patients, 86 (78.18%) were males, while 15 (21.81%) were females. On coronary angiography, there were 25 (24.8%) patients with nonatherosclerotic coronary arteries, 39 (38.6%) with single vessel disease (SVD), 18 (17.8%) had double vessel disease (DVD), and 19 (18.8%) had triple vessel disease (TVD). Of the total, 3 patients (2.97%) had disease in the left main stem. One hundred thirty-two lesions (39x1=39 in SVD; 18x2=36 in DVD 19x3=57 in TVD) were studied. The lesions were mostly discrete to tubular with less diffuse involvement and had either no or mild calcification. Thrombus was found in 5 patients with SVD (12.82%), 2 with DVD (11.11%) and 1 with TVD (1.75%). CONCLUSION: This study showed that young (age 35 years) patients who have sustained AMI, have less extensive coronary artery disease but complex morphologic features. There was a higher incidence of normal vessels on coronary angiography with a very few cases of left main coronary arterial involvement.