Instructor Cardiology Aga Khan Univesity Hospital karachi, Sindh, Pakistan
Background: STEMI is relatively uncommon in patients aged <45 yrs. However, it is prevalent in young South Asian population. The objective in this study was to determine the extent of coronary lesions in Young STEMI patients.
Methods: It was a cross-sectional study done from 2013-2018 on STEMI patients aged <45 years who underwent immediate Coronary Catheterization and Percutaneous Intervention. Patients with previous MI, Coronary artery bypass graft or PCI were excluded. Details of risk factors and Coronary lesion anatomy were noted on a Performa.
Results: Out of 169 patients, 89.9% were male and 9.5% were female. Mean age was 39.5 (+5.1). Mean BMI was 27.9 (+5.7) with 51% obese patients. Family History was positive in 47.9%, Tobacco in 45%, Diabetes in 37%, and Hypertension in 32% patients. Coronary Lesions: Sixty six percent of patients had isolated Single vessel coronary Artery Disease (SVCAD), 23% had Double vessel disease (2VCAD) and 8.9% had Triple vessel disease (3VCAD). Out of these, 76.9% had lesion in Left anterior descending/Diagonal (LAD/D1); of which, 56.2% lesions were between Osteo-proximal to Mid LAD and 29% from mid to distal. Right coronary artery/ Posterior descending artery (RCA/PDA) was involved in 37.3% with 17.8% lesions in between Osteo-proximal to mid RCA and 26% lesions from mid to distal. Left circumflex/Obtuse Marginal (LCx/OM1) was involved in 24.3%, with 11.8% of disease in between osteo-proximal to mid segments and 11.2% of disease from beyond OM1 ostium.
Conclusions: Almost two third patients aged < 45 with STEMI had Single Vessel disease. LAD was the most common culprit vessel and the most common site was Osteo-proximal to mid LAD.
