The Risk Factors in Patients 40 Years and Under with Acute Coronary Syndrome

Aim: In this study, we aimed to analyze the clinical and demographic characteristics and risk factors of young adult patients (aged <40 years) with acute coronary syndrome (ACS). Clinical differences and outcomes related to the sex factor with the treatment modalities applied. Material and Methods: This retrospective study included patients aged 40 years and younger who were treated for acute coronary syndrome in a hospital in Bursa between 2016 and 2020. Results: A total of 63 patients (7.4%) were included in the study. The majority of the patients were male (78%) and the median age was 38 years. Smoking was significantly more common in males than females (97.9% vs. 42.8%, p<0.001). Males had higher creatinine (0.81±0.13 vs. 0.69±0.08 mg/dL, p=0.010) and hemoglobin levels (15±1.3 vs. 11.7±1.6 g/dL, p<0.001), while females had higher RDW (14% vs. 13%, p=0.020) and platelet counts (350±82 vs. 282±63 ×10³/µL, p=0.010). Hyperlipidemia was more frequent in the stent group (72%) compared to CABG (41.2%) and medical groups (10%) (p=0.006). Unstable angina was more common in CABG patients (58.9%), and STEMI in patients with stents (52.9%) (p=0.005 and p=0.040). Glucose and troponin levels were higher in the medical and stent groups, respectively (p=0.020 for both). HDL was higher in the medical group (46±4 mg/dL, p=0.020). Conclusion: The gender- and treatment-related differences in risk factors and biochemical parameters identified in this study may support individualized risk assessment in coronary artery disease. Notably, high smoking rates in males and distinct hematologic features in females merit attention in clinical evaluation.