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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
MEJIA-ZULUAGA, Mateo et al. Acute coronary syndrome at early age. Description of a cohort. Is the risk being properly stratified?. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.1, pp.49-56. Epub Feb 22, 2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.m22000117.
Objective:
To describe the demographic, echocardiographic, angiographic characteristics, clinical presentation, habits, history, and outcomes of patients younger than 50 years attended for acute coronary syndrome (ACS).
Method:
An observational, retrospective and descriptive study was performed, with univariate and bivariate analysis that included information of patients treated at a third level clinic in Medellín, Colombia.
Results and conclusions:
127 cases were identified where 79.5% were men and the most frequent type of ACS was NSTEMI (43%) followed by STEMI (23%). The most prevalent risk factors were overweight, obesity, and changes in the lipid profile (high triglycerides and low HDL), with low prevalence in smoking and diabetes mellitus. 78% of the cases had preserved LVEF with the presence of segmental contractility disorders on baseline echocardiography in 55% of the patients. 20% had severe coronary heart with 3 or more vessel disease. The most frequently compromised coronary artery was the LAD (58.2%). GRACE, Killip-Kimball and TIMI risk scales classified the patients as low risk, being congruent with the hospitalized patients with a mortality rate of 0%; However, clinical criteria should prevail when making decisions about the stratification method and the place (in-hospital or outpatient setting). The need to establish protocols for a functional and structural evaluation of coronary artery microcirculation in patients with a suggestive clinical history, ECG, and positive ischemia induction tests, despite having coronary angiography without epicardial lesions, is demanded.
Keywords : Coronary disease; Cardiovascular disease; Acute coronary syndrome; Age; Young.