Abstract 19078: Coronary Artery Disease in Very Young Adults: Characteristics, Associated Factors and In-Hospital Mortality
Paul M Ndunda, pavida pachariyanon, Joseph Golden, Kenechukwu Nwagbara, Tyler Pierotti, Kyle Felipe Dacdac, Morni Modi, Alison Hawkins, Alyssa Lobello, Kalgi Modi- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Introduction: Premature CAD carries a poor long-term prognosis. However, there is little data on CAD in very young adults. Understanding the characteristics and associated factors in this population is paramount to the prevention and improvement of outcomes of CAD.
Aims To assess characteristics, associated factors, and in-hospital mortality in adults aged 18-35 years with significant CAD (S-CAD) undergoing invasive coronary angiography.
Methods: This is a retrospective cohort study of patients who underwent coronary angiography in a single academic center from 2003-2023. S-CAD was defined as major epicardial CAD with at least 50% stenosis. Chi-square, Fischer exact, and Mann Whitney U tests were used to analyze categorical and continuous variables respectively. Logistic regression was used for multivariable analysis.
Results: A total of 330 patients were included in the study. Patient characteristics are presented in table 1. Factors associated with the incidence of S-CAD include ST elevation, elevated troponin, total cholesterol, LDL, triglyceride, glucose, high WBC & platelet count, low Platelet: WBC ratio, and no cocaine use (p <0.05). On multivariable analysis, ST elevation (OR 5.67 (2.15 - 14.94), high troponin (OR 1.11 (1.03, 1.19), total cholesterol (OR 1.01 (1.01, 1.03), and glucose levels (OR 1.01 (1.01, 1.01) were statistically significant (p<0.05). There was no significant difference in in-hospital all-cause mortality between the group with and without S-CAD (2.2% and 0.8%
respectively; OR 2.75 [0.38, 19.80] p=0.56). Cardiovascular (CV) mortality was 2.2% and 0% respectively (p=0.07). The CV deaths were from STEMI with cardiogenic shock.
Conclusions: Total cholesterol and glucose levels were associated with the incidence of S-CAD. STEMI was the presenting syndrome in a high proportion of patients with S-CAD. Despite young age, in-hospital mortality was similar to published rates in the general adult population.