Arumugam Chandrakasu, Avinash Jayachandran, Chokkalingam Meyyappan, Ganesh Narayan, Pradeep Gopinath Nayar, Ahamed Basha Abdul Bari



Background : Incidence of Coronary artery disease (CAD) among young adults has been rising across the globe.  However, very few data are available regarding CAD in South Indian population.  Hence, the present study was aimed to analyze clinical profile of CAD in young South Indian males.

Methods: Retrospective study was done in 874 males under 50 years of age who underwent coronary angiography between 2009 to 2013.  Age (Group I - < 40 years, Group II- 40 to 49 years), clinical presentation, risk factors for CAD, angiographic findings and management strategy were analyzed.

Results: Group I patients represented 26.9 % (235) of the population and 73.1% (639) were group II.  All the risk factors except diabetes were more frequently present in group II: family history (p = 0.002), smoking (p <0.0001), alcohol consumption (p < 0.0001), hypertension (p = 0.006), dyslipidemia (p < 0.0001) and diabetes (p =0.07).  There was no significant difference in the clinical presentation between the two groups.  Group I were more often advised for coronary artery bypass surgery whereas group II patients required percutaneous coronary interventions frequently.      

Conclusions: Risk factors for CAD have increased among young males in South India with more extensive disease at a younger age with frequent need for revascularization procedures.  Screening for risk factors should start at an earlier age, and smoking cessation, promotion of physical activities and healthy dietary pattern have to be strongly encouraged to this vulnerable group.

Key Words: Coronary Artery Disease, Young Males, Clinical Profile

Full Text:




Choudhury L, Marsh JD. Myocardial infarction in young patients. The American journal of medicine. 1999;107(3):254-61.

Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. CHEST Journal. 1995;108(2):364-9.

Vardan S, Mookherjee S, Sinha A. Special features of coronary heart disease in people of the Indian sub-continent. Indian heart journal. 1994;47(4):399-407.

Gotsman I, Lotan C, Mosseri M. Clinical manifestations and outcome of acute myocardial infarction in very young patients. The Israel Medical Association journal: IMAJ. 2003;5(9):633-6.

Klein LW, Agarwal JB, Herlich MB, Leary TM, Helfant RH. Prognosis of symptomatic coronary artery disease in young adults aged 40 years or less. The American journal of cardiology. 1987;60(16):1269-72.

Janus ED, Postiglione A, Singh RB, Lewis B. The modernization of Asia implications for coronary heart disease. Circulation. 1996;94(11):2671-3.

McKeigue P, Ferrie J, Pierpoint T, Marmot M. Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia. Circulation. 1993;87(1):152-61.

Enas EA, Dhawan J, Petkar S. Coronary artery disease in Asian Indians: lessons learnt and the role of lipoprotein (a). Indian heart journal. 1996;49(1):25-34.

Gupta R. Epidemiological evolution and rise of coronary heart disease in India. South Asian J Prev Cardiol. 1997;1(1).

Noeman A, Ahmad N, Azhar M. Coronary artery disease in young: Faulty life style or heredofamilial or both. Annals. 2007;13(2):162-4.

Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The Lancet. 2004;364(9438):937-52.

Hatch FT, Reissell PK, Poon-King TM, Canellos GP, Lees RS, Hagopian LM. A Study of Coronary Heart Disease in Young Men Characteristics and Metabolic Studies of the Patients and Comparison with Age-Matched Healthy Men. Circulation. 1966;33(5):679-703.

Hoit BD, Gilpin E, Henning H, Maisel A, Dittrich H, Carlisle J, et al. Myocardial infarction in young patients: an analysis by age subsets. Circulation. 1986;74(4):712-21.

de Abreu M, Silberstein A, Mariani J, Cosarinsky L, Gagliardi JA, Doval HC, et al. Clinical and Angiographic Characteristics, Therapeutic Strategies and Outcome of Young Patients with Acute Coronary Syndrome. Argentine Journal of Cardiology. 2012;81(1):22-30.

Zimmerman FH, Cameron A, Fisher LD, Grace N. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). Journal of the American College of Cardiology. 1995;26(3):654-61.

Awan ZA, Hafizullah M. Myocardial infarction in young versus older adults: clinical characteristics and angiographic features. J Ayub Med Coll Abbottabad. 2010;22(2).

Fournier J, Sanchez A, Quero J, Fernandez‐Cortacero J, González‐Barrero A. Myocardial infarction in men aged 40 years or less: A prospective clinical‐angiographic study. Clinical cardiology. 1996;19(8):631-6.

Sheet-Populations SF. International cardiovascular disease statistics. American Heart Association. 2004.

Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. New England journal of medicine. 1998;338(23):1650-6.

Jayachandra S, Agnihotram G, Rao RP, Murthy CV. Risk-factor profile for coronary artery disease among young and elderly patients in Andhra Pradesh. Heart India. 2014;2(1):11.

Mohammad AM, Jehangeer HI, Shaikhow SK. Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq. BMC cardiovascular disorders. 2015;15(1):1.

Tewari S, Kumar S, Kapoor A, Singh U, Agarwal A, Bharti B, et al. Premature coronary artery disease in North India: an angiography study of 1971 patients. Indian heart journal. 2004;57(4):311-8.

Christus T, Shukkur A, Rashdan I, Koshy T, Alanbaei M, Zubaid M, et al. Coronary artery disease in patients aged 35 or less-A different beast? Heart Views. 2011;12(1):7.

Uddin S, Begum F, Malik F, Rahman S. Coronary artery disease in young patients: clinical review and risk factor analysis. Mymensingh medical journal: MMJ. 2003;12(1):3-7.

Cole JH, Miller JI, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. Journal of the American College of Cardiology. 2003;41(4):521-8.


  • There are currently no refbacks.