Clinical profile and risk factors of acute coronary syndrome in young adults: A hospital-based cross-sectional observational study.

Abstract

Background
Acute Coronary Syndrome (ACS) in young adults is being recognized more frequently, particularly in low- and middle-income countries. Understanding clinical presentation and modifiable risk factors in younger individuals is essential for timely prevention and targeted intervention.

Objectives: To assess the clinical profile and identify predominant risk factors among young adults presenting with ACS in an internal medicine department.

 Methods
This observational study included 100 consecutive patients aged 20–45 years admitted with ACS. Diagnosis and classification into STEMI, NSTEMI, or Unstable Angina were based on clinical assessment, ECG changes, and cardiac biomarkers. Relevant history, risk factors, lipid profiles, and coronary angiography findings were recorded using a structured proforma. Descriptive statistics were applied for analysis.

 Results
The mean age of the cohort was 34.8 ± 4.2 years; males comprised 78%. Chest pain was the most frequent presenting symptom (89%), followed by sweating (63%) and dyspnea (41%) (Table 1). Smoking or tobacco use emerged as the predominant risk factor (54%), followed by family history of coronary artery disease (37%), dyslipidemia (35%), and hypertension (31%) (Table 2). STEMI was the most common presentation (48%), with NSTEMI and Unstable Angina accounting for 32% and 20%, respectively (Table 3). Coronary angiography revealed single-vessel disease in 52% of cases, while 11% had normal or minimal disease (Table 4).

 Conclusion
ACS in young adults is strongly associated with modifiable lifestyle factors, especially smoking and dyslipidemia. The predominance of single-vessel involvement suggests a potentially reversible early disease process if timely intervention and long-term risk reduction strategies are adopted.

 Recommendations
Smoking cessation counseling, routine lipid screening in individuals with a family history of CAD, community-based lifestyle modification programs, and early cardiac evaluation for atypical symptoms in young adults should be prioritized. Longitudinal follow-up studies are needed to evaluate long-term outcomes.