Nauman Matloob Ahmed Siddiqui, Khalid Iqbal Bhatti, Muhammed Tariq Farman, Naveed Ullah Khan.
Frequency of risk factors in patients presenting with acute coronary syndrome below 40 years of age.
Pak Heart J Jan ;52(3):240-4.

Objective: To determine the frequency of factors leading to acute coronary syndrome in patients below 40 years of age presenting to tertiary care center. Methodology: This descriptive cross sectional study was conducted at National Institute of Cardiovascular Disease, Karachi from 20th August 2015 to 19 February, 2016 for six months. Individuals of both genders with age below 40 years presented with acute coronary syndrome for first time were included.Patients with valvular heart disease, congenital heart disease, Congestive cardiac failure, chronic renal and respiratory failure were excluded from the study. Results: Total of 86 patients were included. The average age of the patients was 35.80 +- 4.21 years (95%CI: 34.89 to 36.71). Out of 85 patients, 72 (85%) were males and 13 (15%) were females with 5.54:1 male to female. ratio. ST-segment elevation myocardial infarction (STEMI) was observed in 38 (44.7%) cases, non-ST-segment elevation myocardial infarction (NSTEMI) was seen in 20 (23.5%)cases and unstable angina (UA) was observed in 27 (31.8%) patients. Family history was the commonest factor leading to acute coronary syndrome observed in 45 (52.9%) cases followed by smoking [31 (36.5%)], Obesity [14 (16.5%)].dyslipidemia [13 (15.3%)], diabetes mellitus [10 (11.8%)] and hypertension observed in [5 (5.9%)] cases. Smoking was commoner in higher age groups(p=0.013).Comparison of factors of acute coronary syndrome between male and female revealed that smoking, family history, diabetes mellitus, hypertension were significantly higher in male patients than female. Conclusion: Family history emerged as a most common risk factor associated with acute coronary syndrome in young individuals.

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