Comparative analysis of young acute coronary syndrome in pre and post covid pandemic

Abstract Introduction The rising incidence of ACS in young patients has garnered significant attention because of the clinical implications that come with incorrect or delayed diagnosis and treatment. There are several pathologic causes for ACS in this population that can be categorized into atheromatous, non-atheromatous, and thromboembolic causes. There is an increasing trend of young patients presenting with ACS especially in recent years .The covid pandemic also has contributed to the surge in young ACS. This article focuses on the practical concerns related to gender differences and incidence in young ACS between Pre and Post covid pandemic. Aim To study clinical and angiographic profile of young ACS patients in the pre and post covid pandemic period. Methodology The Observational study was conducted at a Tertiary Care Hospital in South(19.3%) India from January 2018 to December 2023. All the young patients18-45 years admitted with acute coronary syndromeACS were included.ACS was diagnosed by history ,clinical evaluation, serial ECGs, serial biomarkers and echocardiography. Patients with ACS were subjected to coronary angiography with consent. Results The yearly database from January 2018 to December 2023 are as follows. Out of 10,842 patients in last 6 years, 2457 patients were young ACS (22.66%), Out of the 2457 young ACS patients, 600 were female (24.4%) The incidence on yearly basis were recorded as,In 2018, total angiography done was 1657, out of which 315 were young. In 2019 , total angiography done was 1632, out of which 380 were young. In 2020 , total angiography done was 806, out of which 202 were young. In 2021, total angiography done was 1605, out of which 480 were young. In 2022, total angiography done was 2474, out of which 564 were young. In 2023, total angiography done was 2668, out of which 516 were young The angiographic data of young ACS: SVD is 47.7%, DVD is 30.3%, TVD is 12.8%, LMCA involvement 9.2% Statistical Analysis: Variable (2018 to 2020) (2021 – 2023) Total Chi-square test P –value Young MI (men + Women) 897 (36.5%) 1560 (63.5%) 2457 (100%) 8.95 0.003 Conclusion After the covid pandemic , the total incidence of ACS increased drastically, especially among the young individuals out of which the incidence of ACS in young women also has an increasing trend.Thrombus burden is high in post covid patients.The postulation that Covid tends to mitigate the protective estrogenic effect in young females has to be further validated. In addition, future research should focus on developing risk stratification models for young patients so as to prevent and treat early the younger generation so as to reduce the overall incidence and mortality of ACS in the young .YEARLY DATA OF YOUNG ACS STATISTICAL ANALYSIS