Clinico-investigative assessment and comparison of cardiovascular risk factors in young and elderly patients of acute coronary syndrome

Background: Coronary artery disease in Indians occurs at an earlier age than most other populations. Risk profile and angiographic severity of young acute coronary syndrome (ACS) patients differ from those in the elderly. Methods: This cross-sectional study included 46 young (?45 years) and 45 elderly (>45 years) ACS patients. Clinical features, risk factor profiles and coronary angiograms of these patients were studied and compared. Results: Compared with the elderly, more young patients had chest pain and ST-elevated myocardial infarction. Smoking, atherogenic dyslipidemia and abdominal obesity were most frequent in young, while hypertension, high low-density lipoprotein (LDL) cholesterol and abdominal obesity were most prevalent in elderly. High serum homocysteine was the most prevalent novel risk factor in either group. Serum Lp(a) was significantly higher in the young group compared to elderly (p = 0.03). Angiographically, multivessel coronary disease and high Gensini score were more common in elderly. Young group had a low positive correlation between serum triglyceride level and Gensini score (rs = 0.33, p = 0.03). In the elderly, fasting blood glucose and serum triglyceride levels had low positive correlation with Gensini score (rs = 0.36, p = 0.01 and rs = 0.32, p = 0.04 respectively). Conclusions: Cardiovascular risk factors differ in young and elderly ACS patients. Lifestyle changes and behavioral modifications should be emphasized to prevent the development of ACS in the young Indians.