Pattern of Coronary Artery Disease in Patients Under 50 Years of Age with Acute Coronary Syndrome

Abstract

Objective: To determine the angiographic patterns and severity of coronary artery disease (CAD) in patients aged ≤50 years presenting with acute coronary syndrome (ACS) at a tertiary care hospital.
Study Design: Hospital based cross sectional analytical study.
Place and Duration of Study: Department of Cardiology, PAEC General Hospital, Islamabad, from January 1 and June 30, 2025.
Materials and Methods: Consecutive patients aged 30–50 years presenting with STEMI, NSTEMI, or unstable angina who underwent coronary angiography were enrolled. Demographic characteristics, cardiovascular risk factors, and angiographic findings were recorded. Data were analyzed using SPSS version 26.0. Associations between risk factors and CAD severity were assessed using the chi-square test, with p <0.05 considered statistically significant.
Results: Ninety patients were included (mean age 44.94 ± 3.94 years), with 67.8% males. STEMI was the most frequent presentation (74.4%), followed by unstable angina (16.7%) and NSTEMI (8.9%). After angiography single-vessel disease was observed in 37.8% of patients, double-vessel disease in 22.2%, triple-vessel disease in 11.1%, 28.9% had normal coronary arteries. Hypertension (55.6%) and smoking (40%) were the most prevalent risk factors.
Conclusion: Among young adults presenting with ACS, STEMI is the predominant clinical presentation, and single-vessel CAD is the most frequent angiographic pattern. A considerable proportion had normal coronary arteries, highlighting the need for further evaluation of non-obstructive mechanisms in young ACS patients.