A STUDY OF CLINICAL & ANGIOGRAPHIC PROFILES OF YOUNG ACUTE CORONAY SYNDROME PATIENTS IN SOUTH INDIAN POPULATION IN THE POST COVID ERA
Authors: Pallem Aakash , Swaminathan Swaminathan , Ravindran Ravindran 
Published: August 2023

Background Background: Acute myocardial infarction (AMI) has been reported more frequently in young individuals. The disease results in
high mortality if not adequately diagnosed or treated. The current study aimed to evaluate the clinical & angiographic prole of patients with Acute
coronary syndrome(ACS) in patients aged less than 40 years of age in the post covid era. Methods: A prospective cross-sectional study was
conducted on a total of 800 patients out of which 169 patients had an Acute coronary syndrome(ACS) i.e unstable angina(UA), Non-ST-elevation
myocardial infarction(NSTEMI) (or) ST-elevation myocardial infarction(STEMI)at an age less thanor equal to 40 years in the Cardiology
Department of a tertiary care hospital in South India for a period of one year(jan2022-jan2023). Patients underwent angiographic tests for the
assessment of angiographic proes and mortality was assessed during hospital stay. Results:Atotal of 800 ACS patients were analysed over a time
period of one year i.e from jan 2022 to jan 2023 out of which there were 169 patients (21%) presented with young MI i.e less than 40 years who
presented with UA/NSTEMI/STEMI.Out of the 169 patients with young MI,10 patients (5.9%) were less than 30 years. Majority of patients with
young MI(101 patients,59.8%) were more than 36 years with patients with a male predominance (74%). Family history of coronary artery disease
was reported in 61.5% of individuals, whereas 38.5% did not have a family history. Dyslipidemia was the most commong co-morbidity which was
present in 34.3% of patients out of which only 1 patient had a familial hypercholesterolemia.diabetes was the second most common co-morbidity
that was present in 30.8% patients with the young MI followed by hypertension which was present in 21.9% patients.Most common presentation of
disease was STEMI which was present in79.9% (135 patients)patients with Anterior wall MI (AWMI) being the most common ECG presentation
with Left anterior decending artery(LAD) being the most commonly involved artery on angiography(56.8%).Severe Ejection fraction(EF)
impairment was reported in 8% of patients, while 40% of young ACS patients presented with normal EF.The most common angiographic presentation was single vessel disease(SVD) which was prevalent in 66.9% of cases . Factors such as EF, Killip class, involvement of multiple vessels on angiography were signicantly associated with death (p < 0.05). Mortality was observed in 6 patients (3.6%) with a signicant correlation to severity of myocardial disease at presentation in the form of EF & Kilip class. Conclusion: These ndings suggest that left ventricular function, the extent of coronary artery disease, the involvement of specic coronary arteries, and vascular recanalization on angiography all play signicant roles in predicting patients death.Alarger cohort study with a long-term follow is warranted to analyze the detailed ACS progression status in young individuals in india