International Journal of the Cardiovascular Academy (Jan 2020)

Clinical and angiographic profile of CAD in young smokers

  • Laxmi H Shetty,
  • K C Sheetal,
  • Vivek G Chandrashekar,
  • Rahul S Patil,
  • J R Vijaykumar,
  • Veeresh Patil,
  • Hema Raveesh

DOI
https://doi.org/10.4103/IJCA.IJCA_42_20
Journal volume & issue
Vol. 6, no. 4
pp. 164 – 168

Abstract

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Introduction: The aim was to study the clinical, social, biochemical, and angiographic profile of premature coronary artery disease (PCAD) in young smokers. Subjects and Methods: The PCAD registry has 3450 patients till date, of which 1985 (57.53%) patients fulfilled the entry criteria: tobacco smokers. The entire clinical data, biochemical parameters, and angiographic profiles of these patients were documented. The data were analyzed by statistical software R version 3.5.0. Results: The study enrolled 1985 patients after satisfying the entry criteria. The mean age of this study group was 33.97 years, with 100% male population. A total of 140 (7.05%) patients had diabetes mellitus, 246 (12.39%) had hypertension, and 269 (13.55%) patients had a strong family history of PCAD. Majority of them (1415 [71.28%]) had abdominal obesity; polycythemia was seen in 738 (37.17%) patients. One thousand three hundred and three (65.06%) patients had low high-density lipoprotein (HDL) cholesterol, 293 (14.76%) patients had elevated low-density lipoprotein (LDL) cholesterol, and 656 patients (33.04%) had elevated triglycerides. The most common index presentation of coronary artery disease (CAD) in these patients was ST elevation myocardial infarction (STEMI) seen in 1583 (79.74%) patients. One thousand six hundred and eighty-nine (85.08%) patients underwent coronary angiography, of which 999 patients (59.16%) had recanalized/normal/nonobstructive coronary arteries. Six hundred and ninety-five patients (41.14%) had significant CAD, of which 77 patients (4.55%) particularly had high thrombus containing lesions. Ultimately, 1441 (71.08%) were treated only with optimal medical therapy. Five hundred and thirty-six patients (27.01%) underwent revascularization in the form of angioplasty (515 patients) and coronary artery bypass surgery (21 patients). Conclusions: Common presentation of PCAD in young smokers was acute coronary syndromes predominantly as STEMI. Polycythemia and other conventional risk factors such as low HDL cholesterol levels, elevated LDL cholesterol levels, and abdominal obesity are also seen commonly in this subgroup.

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