In young Gujarati patients with symptomatic premature CAD and no conventional risk factors, 50% had elevated LDL cholesterol, 31.6% had elevated lipoprotein A, and 16 of 22 showed predominantly single-vessel disease with LAD involvement; STEMI presentations were more frequent in single-vessel disease while NSTEMI presentations were more frequent in multivessel disease (OR=39.67, 95% CI 1.28-1229.94, p=0.018).
Cross-Sectional (n=22)
No
In young patients with premature CAD lacking conventional risk factors, a high prevalence of unrecognized dysglycemia, dyslipidemia, and elevated Lipoprotein A highlights the importance of non-conventional risk factor screening.
Background With the prevalence of coronary artery diseases (CAD) on the rise, especially in the younger population, characterization of non-conventional risk factors remains essential, especially in the inherently predisposed Southeast Asian population. This study aimed at clinical and biochemical profiling in angiographically proven CAD in young Gujarati Indians without conventional risk factors such as tobacco/alcohol consumption. Methodology This single-center, descriptive, cross-sectional case series included consecutive Gujarati patients aged ≤45 years presenting with symptomatic, angiographically significant CAD over a 15-month period. Patients with tobacco or alcohol exposure and those with concomitant pre-existing diabetes mellitus and hypertension were excluded. Clinical characteristics, biochemical parameters (glycated hemoglobin, lipid profile, lipoprotein A (LpA), homocysteine, apolipoproteins), and coronary angiographic findings were recorded. Analyses were primarily descriptive, with limited exploratory comparisons. Results Overall, 2/4 obese patients (50%) and 3/4 obese patients (75%) were newly diagnosed with dysglycemia and dyslipidemia, respectively. Among patients with single-vessel disease (SVD; n = 16), eight (50%) patients presented with ST-segment elevation myocardial infarction, whereas among those with multi-vessel disease (MVD; n = 6), three (50%) patients presented with non-ST-segment elevation myocardial infarction. Elevated low-density lipoprotein cholesterol levels were observed in 8/16 (50%) patients with SVD and 3/6 (50%) patients with MVD. More than 5/6 (83.3%) patients with elevated LpA had SVD. Conclusions The study showed that non-conventional risk factors, such as obesity and family history of CAD, when combined with LpA and lipid profiles, can help in earlier identification of a predisposed individual in a high-risk population.
Pujara et al. (Wed,) conducted a cross-sectional in Symptomatic premature coronary artery disease (n=22). In young Gujarati patients with symptomatic premature CAD and no conventional risk factors, 50% had elevated LDL cholesterol, 31.6% had elevated lipoprotein A, and 16 of 22 showed predominantly single-vessel disease with LAD involvement; STEMI presentations were more frequent in single-vessel disease while NSTEMI presentations were more frequent in multivessel disease (OR=39.67, 95% CI 1.28-1229.94, p=0.018).