276 JACC March 21, 2017 Volume 69, Issue 11
Acute and Stable Ischemic Heart Disease CHARACTERISTICS OF ACUTE CORONARY SYNDROME PRESENTATION IN YOUNG PATIENTS Poster Contributions Poster Hall, Hall C Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m. Session Title: Unusual Presentations of ACS Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical Presentation Number: 1297-322 Authors: Bill Ayach, Christopher Hayes, Malek Kass, John Ducas, James Tam, Francisco Cordova, Olga Toleva, Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
Background: Acute coronary syndrome (ACS) is a major cause of death worldwide. ACS is primarily thought to occur in the elderly and less frequently in adults younger than ≤35 years of age. In this study, we proposed to analyze the presentation of ACS, risk factors, and description of coronary artery disease (CAD) in young patients.
Methods: A retrospective analysis was performed on all patients ≤35 years old between 2010 and 2015, who were referred to angiography for suspicion of ACS. Evaluation of risk factors, labs, as well as CAD description (single vs. multiple lesions) was done, and grouped into Non-STE ACS (Unstable angina and NSTEMI) vs. STE ACS (STEMI). Results: A total of 110 patients met the above criteria, with 61 having angiographic evidence of ACS (55.4%) and were divided into three groups: 32 Non-STE ACS, 27 STE ACS, and 2 with spontaneous coronary artery dissection. Of all 110 patients 40 patients had no evidence of CAD and non-cardiac cause for their symptoms (36.3%), 4 patients had non-ACS cardiac pain (myopericardits or myocarditis) (3.6%), and 5 lost records (4.5%). See Table 1 for characteristic of non-STE ACS vs. STE ACS.
Conclusions: Our findings demonstrate that the majority of patients ≤35 years old suspected of ACS and referred to angiography (55.4%) did in fact have evidence of CAD. Patients with Non-STE ACS were significantly more likely to be males and have multi vessel disease. There was also a non-significant trend to increased risk of diabetes and dyslipidemia in the Non-STE ACS vs. STE ACS.