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Coronary Heart Disease (CHD) remains a major cause of death in Bangladesh. CHD in younger age is not, simply a problem of sufferers but a huge emotional and economic loss to the family.
This study looked at the demographic data & risk profile of very young patients presenting to a busy tertiary PCI center in Dhaka, Bangladesh.
This prospective data was collected on patients who underwent coronary angiography over a 6-month period from January–June 2015. “Young” was defined as ≤35 years of age.
Young patients comprised 15.4% (n=60) of all patients in this period. Mean age was 32.1 ± 3.1 years and only 15% (n=9) were obese. Male sex (70%), hypertension (41.7%), dyslipidemia (30%) and smoking (23.5%) were the major conventional risk factors followed by diabetes mellitus (23.3%). The family history of premature CHD was seen in 12.9%. Mean ejection fraction was 52.4 ± 12.3%. Clinical presentation was STEMI in 24 (40%) patients, NSTEMI in 5 (8.3%) and UA in 9 (15%) patients. 8.3% (n=5) received thrombolytic therapy. Angiography was performed via the right radial access in 90% and via left radial access in 10% patients. SVD was seen in 20 (33.3%) young patients while 12 (20%) and 2 (3.3%) patients had a double vessel and triple vessel disease respectively. Normal coronaries were noted in 18 (30%) patients while 4 (6.7%) had recanalized IRA and 1 (1.6%) had pure ectasia. LAD was the main artery involved in 28 (46.6%) patients while LCx and RCA were involved in 11 (18.3%) and 15 (25%) patients respectively. 27 of the young patients required coronary revascularization. 24 (33.3%) were performed percutaneously with DES and 3 (5.0%) had surgical revascularization. Of the PCI cohort, 3 (12.5%) patients underwent primary PCI and 1 (4.1%) underwent POBA. 19 (79.2%) patients required 1 stent while 5 (20.8%) patients required 2 stents during PCI.
Mean stent diameter and length were 2.7 ± 0.2 and 21.0 ± 8.4 mm respectively. There were no in-hospital deaths, MI or cerebrovascular events.
Very young adults had significant CAD which warrants extremes of preventive steps and also revascularization to prevent reoccurrence of fatalities due to CAD.