Clinicodemographic and angiographic profiles of young patients with coronary artery disease undergoing coronary angiography in India

Background: Coronary artery disease (CAD) in young individuals is an emerging public health concern, particularly in low- and middle-income countries. However, contemporary data describing the clinicodemographic characteristics and angiographic spectrum of CAD in young patients in India remain limited. Materials and Methods: This retrospective observational study included patients aged ≤45 years who underwent coronary angiography for suspected CAD at a tertiary cardiac center in Pune, India, between October 2024 and September 2025. Demographic characteristics, cardiovascular risk factors, clinical presentation, left ventricular ejection fraction (LVEF), angiographic findings, and management strategies were analyzed. Associations between clinical predictors and CAD severity were assessed using chi-square/Fisher’s exact tests and univariate multinomial logistic regression. Results: Among 194 patients, 76.8% were male, and most were aged 41–45 years. Smoking was the most prevalent risk factor (57.2%). ST-elevation myocardial infarction (STEMI) was the predominant presentation (54.1%). Notably, single-vessel disease (SVD) emerged as the dominant angiographic pattern (49.0%), most commonly involving the left anterior descending (LAD) artery. Reduced LVEF was significantly associated with multi-vessel disease (MVD; P = 0.007), whereas diabetes mellitus was significantly associated with obstructive and MVD ( P < 0.001). Smoking was significantly associated with STEMI presentation. Conclusion: In this tertiary care study, CAD in young individuals predominantly affected males and commonly presented as STEMI. Angiographically, SVD with predominant LAD involvement was the most frequent pattern. Smoking and diabetes emerged as important modifiable risk factors, whereas reduced LVEF was associated with more extensive coronary involvement, underscoring the need for early risk stratification and aggressive risk-factor control in young individuals with CAD.