Objective To investigate the prevalence and characteristics of coronary artery disease in a cohort of young adults (<45 years) using coronary computed tomography angiography and to integrate these local findings with the established literature. Methods We retrospectively analyzed 184 consecutive patients aged 18-45 years who underwent coronary computed tomography angiography for the investigation of chest pain or cardiovascular risk stratification. The cohort included both symptomatic individuals and asymptomatic patients with established risk factors. The data extracted included coronary artery calcium score, luminal stenosis, plaque morphology, and congenital anomalies. Results The mean age was 38 years; 79.3% were male. Normal coronary arteries were found in 72.3% ( n = 133). Subclinical atherosclerosis was detected in 27.7% ( n = 51), with obstructive coronary artery disease (≥50% stenosis) in 8.2% ( n = 15). A non-zero coronary artery calcium score was present in 12.5% ( n = 23), with values up to 549. High-risk, non-calcified plaques were observed even in patients with a zero coronary artery calcium score. Myocardial bridging was identified in 22% of the cohort. Conclusion Although the overall prevalence of obstructive coronary artery disease is low in young Indian adults, subclinical atherosclerosis and high-risk plaque features are not uncommon. Coronary computed tomography angiography enables early identification of these abnormalities and should be considered in the targeted evaluation of high-risk young patients in India.
Sharma et al. (Fri,) studied this question.