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Precocious virulent coronary atherosclerosis in the very young

Published online by Cambridge University Press:  31 August 2011

Robert Chait ,
Rajesh Ramineni  and
Erin A. Fender
Robert Chait*
Affiliation:
Internal Medicine and Cardiology, JFK Medical Center, Miller School of Medicine, University of Miami, Atlantis, Florida, United States of America
Rajesh Ramineni*
Affiliation:
Internal Medicine and Cardiology, University of Texas Galveston, Galveston, Texas, United States of America
Erin A. Fender
Affiliation:
Internal Medicine, School of Medicine, University of Miami, Miami, Florida, United States of America
*
Correspondence to: Dr R. Chait, MD, 2413 Embassy Drive, West Palm Beach, Florida 33401, United States of America. Tel: 561 301 4633, Fax: 561 478 9505; E-mail: bobchait@gmail.com
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Abstract

Background

The incidence of Myocardial Infarction (MI) in patients under the age of 30 has been rarely addressed. Moreover, it is not understood why these patients develop symptomatic Coronary Artery Disease (CAD) at such an early age. Traditional risk factor assessment has not been successful in identifying these patients before they present with MI.

Methods

Retrospective, single cohort, observational study of 14,704 cardiac catheterizations performed in a community hospital between January 2006–January 2010 identified 12 cases age <30 with MI secondary to a fixed atherosclerotic lesion requiring angioplasty and stenting. The angiograms and charts were reviewed to assess the incidence and frequency of traditional risk factors such as smoking, dyslipidemia and diabetes and family history.

Results

All the patients had single vessel disease. Many of the patients were noted to have traditional CAD risk factors. 2 patients had an intervention and then months later sustained another acute MI secondary to a new culprit lesion despite aggressive risk factor modification.

Conclusion

Evaluating patients for premature CAD by screening for traditional risk factors has not effectively identified at risk patients prior to presentation with MI. There is a role for studies evaluating new and novel risk factors and imaging modalities so that these patients can be identified prior to experiencing MI.

Keywords

Premature coronary artery diseasecocainerisk factors
Type
Original Articles
Information
Cardiology in the Young , Volume 22 , Issue 2 , 02 March 2012 , pp. 184 - 187
Copyright
Copyright © Cambridge University Press 2011

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