Clinical and Angiographic Profile of Heart Attacks in Teenage Indians

Abstract

Rahul Shankar Patil1 , Sheethal K.C.2 , Srinidhi S. Hegde3 , Laxmi H. Shetty4 , Aman Sinha5

BACKGROUND We wanted to study clinical, social, biochemical and angiographic profile of Indian youth in their teens (13 to 19 yrs. age) with Premature Coronary Artery Disease (PCAD). METHODS This is a prospective ongoing descriptive observational study of Indians aged below 40 years with Coronary Artery Disease which was started on 1st April, 2017. Of 3450 patients registered in PCAD registry till date, 17 satisfied entry criteria. Entire clinical and angiographic profile of these patients was documented. Conventional lipids were estimated using commercially available kits. The distribution of different lipid profile parameters was visualised by nonparametric density plot. The data was analysed by statistical software R version 3.5.0. RESULTS 17 out of total of 3450 patients (0.6%) registered under PCAD registry belonged to study age group for this particular study. The mean age of all patients under PCAD registry was 18.34 years. 1 patient each was 15 and 16 years old, two and four seventeen-year olds and majority (9) of them were 19 years. Average age of this study group was 18.345 yrs. A majority of 16 (94%) of the patients were males. 8 (47.10%) were smokers. 1 patient (5.8%) was diabetic and 1 patient (5.8%) was hypertensive. 2 (11.7%) had strong family history of premature coronary artery disease. Most common index presentation of coronary artery disease in teenage Indians was with ST elevation myocardial infarction (10 patients – 58.9%), and unstable angina / Non-ST elevation MI (2 patients – 11.7%). 3 patients (17.6%) presented with evolved myocardial infarction, 2 patients (11.6%) presented with spontaneous myocardial infarction. Mean total cholesterol of entire study population was 171.95 ± 47.11, LDL was 116.39 ± 84.81 mg/dL, HDL was 34.50 ± 9.64, TG was 165.18 ± 87.11, non-HDL was 138.09 ± 46.18. CONCLUSIONS Previous Studies have shown that atherosclerotic plaques or their precursors can be seen in children younger than 10 years (2 – 5). During later life, effect of sedentary lifestyle, coupled with unhealthy nutrition, smoking, alcohol consumption, obesity and family history of cardiovascular disease accelerates atherosclerotic disease. The problem in India is the incomplete detection, treatment, and control of CAD risk factors. Larger sample population studies are needed to draw population specific cut-off values for risk factors and to discover novel risk factors.

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