Abstract
Objectives: This study was designed to assess characteristics of coronary arterial lesion by means of invasive coronary angiography in young patients, less than age 35 years, who sustained acute myocardial infarction.
Methodology: This prospective study was conducted from December 2009 to November 2010 at the cardiology departments of all the three tertiary care hospitals in Peshawar. Total duration of the study was one year. All patients aged <35 years who were evaluated angiographically after an acute myocardial infarction were included. The individual coronary arterial lesions were characterized.
Results: A total of 101 patients with acute myocardial infarction underwent coronary. angiography. Mean age of the patients was 32.56 +/- 3.26 years (range 22 - 35 years). About eighty-six patients (78.18%) were males. As revealed by the coronary angiography, there were 25 (24.8%) patients with non-atherosclerotic coronary arteries, 39 (38.6%) with single vessel disease, 18 patients (17.8%) had double vessel disease, and 19 patients (18.8%) had triple vessel disease.Of the total, 3 patients (2.97%) had disease in the left main stem. As far as the length of the lesions is concerned, the lesions were mostly discrete to tubular with less diffuse involvement.The lesions mostly either had no or mild calcification. Thrombus was found in 5 patients with SVD (12.82%), 2 patients with DVD (11.11%) and 1 patient with TVD(1.75%).These lesions were located mostly in the ostial to proximal segments, and were mostly severely to completely occlusive disease. Type A lesions were found in 14%, type B1 in 33%, type B2 in 27%, type C1 in 25%, and type C2 in none.
Conclusion: We found that young (age < 35 years) patients who have sustained myocardial infarction, have less extensive coronary artery disease but complex morphologic features, with a high incidence of angiographically normal vessels and relative paucity of left main coronary arterial involvement.