Patterns of Coronary Artery Disease in Patients under 40 with Acute Coronary Syndrome

Abstract

Background: In adult patients under 40 years of age, acute coronary syndrome can result in significant morbidity.

Objective: To identify the angiographic characteristics of coronary artery disease in young patients (< 40 years) with acute coronary syndrome.

Methods: This descriptive cross-sectional study involved 120 patients (18-39 years) with acute coronary syndrome (ACS) from March to August 2025 at Aga Khan University Hospital, Karachi. Demographic, risk factor, and coronary angiographic data were analyzed.

Results: The mean age was 34.2 ± 4.1 years, and 85.0% were male. The most common presentation (56.7%) was STEMI. The top risk factors were smoking (59.2%) and dyslipidemia (48.3%). Single-vessel disease was the most common (54.2%), and the left anterior descending artery was the most commonly affected (58.3%).

Conclusion: Single-vessel disease with LAD involvement predominated in young ACS patients and suggests the importance of early risk-factor control and prompt angiographic evaluation.