Login | Users Online: 1525  
Home Print this page Email this page Small font sizeDefault font sizeIncrease font size   
Home | About us | Editorial board | Search | Ahead of print | Current Issue | Archives | Submit article | Instructions | Subscribe | Advertise | Contact us

Table of Contents
Year : 2011  |  Volume : 12  |  Issue : 1  |  Page : 7-11  

Coronary artery disease in patients aged 35 or less - A different beast?

1 Department of Cardiology, Chest Diseases Hospital, Ministry of Health, Kuwait
2 Faculty of Medicine, Kuwait University, Kuwait

Date of Web Publication25-May-2011

Correspondence Address:
T Christus
Interventional Cardiologist, Chest Diseases Hospital, P.O.BOX - 4082, Safat, 13041
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1995-705X.81550

Rights and Permissions

Aim: To assess the extent and severity of coronary artery disease (CAD) in 200 consecutive patients aged 35 years or less undergoing diagnostic coronary angiography.
Patients and Methods: Findings in these 200 patients (≤ 35 years of age) were analyzed to find the extent and severity of CAD. The mean age was 31.69 (±3.76) years. Majority were males (94%) and from the Arab ethnicity (70.5%).
Result: Smoking (71%) and history of premature CAD (27%) were the most frequent risk factors (RF). History of previous ST elevation myocardial infarction (MI) was present in 68%. Anterior wall MI was the most frequent location (63.3%). The majority (54.3%) had moderate or large size MI. Ejection fraction (EF) less than 50% was noted in 30.3%. Left main or triple vessel CAD was seen in 15%. One- and two-vessel CAD was seen in 32.5% and 19% patients, respectively. Coronary angiogram was completely normal in 23.5%. The majority (54.5%) were treated conservatively and the rest (45.5%) needed percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The mean number of stents used was 1.3 ± 0.67 and the mean length of stents used was 20.3 ± 12.6 mm.
The extent and severity of CAD was very significant in this subgroup of very young (≤35 years) Asian patients. Smoking was the main risk factor and half of the patients needed either PCI or CABG.

Keywords: Coronary artery disease; premature coronary artery disease, young patients, ethinicity

How to cite this article:
Christus T, Shukkur A M, Rashdan I, Koshy T, Alanbaei M, Zubaid M, Hayat N, Alsayegh A. Coronary artery disease in patients aged 35 or less - A different beast?. Heart Views 2011;12:7-11

How to cite this URL:
Christus T, Shukkur A M, Rashdan I, Koshy T, Alanbaei M, Zubaid M, Hayat N, Alsayegh A. Coronary artery disease in patients aged 35 or less - A different beast?. Heart Views [serial online] 2011 [cited 2023 Dec 2];12:7-11. Available from: https://www.heartviews.org/text.asp?2011/12/1/7/81550

   Introduction Top

Manifest coronary artery disease (CAD) in a young person can have devastating consequences to the patient and to the family. [1],[2] Many studies take age <40 years when choosing to study young patients with CAD. [3],[4],[5] Patient subgroups <35 years are at times referred as very young. [4] Studies in young patients focus on the clinical presentation, severity of the disease, presence of risk factors, and prognosis. [6],[7],[8],[9]

It is estimated that about 10% of individuals presenting with documented CAD are <45 years of age. [9] This estimate could vary considerably depending on the population at study. For example, it is known that patients from the Indian subcontinent present relatively early and may have more extensive CAD compared to their counterpart from other ethnic groups. [10],[11],[12],[13],[14] We also know that traditional risk factors of CAD seen in the elderly age group do not apply to younger age group. [5],[6],[15],[16]

Angiographic data regarding the extent and severity of CAD in the very young patients with manifest CAD is very limited. The limited data seem to suggest higher prevalence of single vessel CAD and less of triple vessel CAD in the young. A study from the UK found more complex stenosis morphology in the younger patients compared to the older. [15] On the other hand one angiographic study from North India found less diffuse disease in the younger patients. [17]

It is also known that the long-term prognosis and functional status of young patients who have acute myocardial infarction (MI) is not benign. [18] Though percutaneous coronary intervention has been done successfully in young patients with very promising short-term results; [19],[20] in the long term there was need for repeat revascularization in a significant proportion of patients. [19] Encouraging results have been reported in young patients undergoing CABG. [21],[22],[23],[24] Lytle et al.[21] from the Cleveland Clinic have reported excellent 5-year survival in 107 patients ≤35 years undergoing CABG. Similar encouraging results were reported by Fitzgibbon et al.[22] in 138 men ≤39 years old.

If we want to understand the complexities of manifest CAD in the young, we need to study patients from different population subgroups in detail. Though there are studies on CAD in the young, overall there is a paucity of detailed studies from various geographical and ethnical subgroups. Also angiographic studies are very few and do not analyze the details of angiographic morphology.

Therefore, we analyzed the ethinicity, extent and severity of CAD in the very young in patients undergoing diagnostic coronary angiography in our hospital.

   Patients and Methods Top


Two hundred consecutive patients aged ≤35 years undergoing diagnostic coronary angiography (CAG) were enrolled in the study. Relevant historical details were gathered and entered in a specially prepared questionnaire. Height and weight were measured and the body mass index (BMI) expressed as kg/m 2 was calculated. BMI more than 25 and ≤30 was considered overweight and >30 as obesity. Overnight fasting samples were obtained for the blood tests.


Diagnsotic CAG was performed from the right femoral artery using the standard percutaneous techniques. Selective left and right coronary angiograms were performed in multiple angulated views. In most cases left ventricle (LV) was entered and the left ventricular end diastolic pressure (LVEDP) was measured. LV angiography was done in the right anterior oblique projection. LV ejection fraction (EF), extent of myocardial wall motion abnormality (to assess the size of the MI), and the severity of mitral regurgitation (MR) if any were noted.


Detailed analysis of the angiographic images was done by two experienced interventional cardiologists. With regard to the coronary arteries attention was paid to the presence of any luminal narrowing and to the number of coronary vessels and segments involved. Morphology of the lesions and other angiographic abnormalities were also documented. Eye-balling method was used to estimate the percentage and length of the lesions. Depending on the degree and extent of regional wall motion abnormality, MI size was estimated as small, medium, or large.

Coronary artery segments studied

We evaluated the following coronary artery segments separately to assess the extent and severity of disease. Left main coronary artery, proximal, mid and distal left anterior descending (LAD) artery segments, major diagonal branches, proximal, mid and distal circumflex artery segments, major obtuse marginal branches (in addition Ramus Intermedius branch if present), proximal, mid and distal right coronary artery (RCA) segments, posterior descending artery (PDA), and posterolateral (PL) segments.

Data was entered and analyzed using SPSS version 13.

   Results Top

Demographic features

Out of 6918 patients catheterized during a 36-month period, there were 200 patients ≤35 years of age. Their mean age was 31.69 (± 3.76) years with a range of 19-35 years. There were 188 males (94%) and 12 females (6%). The major proportion (68.9%) of the patients was Arabs and the rest was mostly from the Indian subcontinent.

Risk factors for CAD

Risk factor profile was fully evaluated [Table 1]. As expected, smoking was the most common risk factor seen in 71% (142/200). Obesity (BMI more than 30 kg/m 2 ) was seen in 20% and overweight (BMI more than 25 kg/m 2 ) in 39%. Family history of CAD was obtained in 27% of patients, whereas hypertension and diabetes mellitus were seen only in 19.5% and 17%, respectively. Mean serum LDL cholesterol was 3.27 mmol/L (±0.14) with 36.5% having values >3.4 mmol/L and 70% having values >2.5 mmol/L. Serum total cholesterol >4.9 mmol/L was seen in 42.7%.
Table 1: Baseline features and coronary risk factors in patient population

Click here to view

Indications for CAG

Most of the patients (72.5%) were referred for CAG after acute coronary syndrome. History of prior MI was obtained in 68% [Table 2].
Table 2: Symptoms at presentation

Click here to view

Other features

In the 136 patients with history of MI, involvement of the anterior wall was the most common and was seen in 63.3% [Table 3]. Clinical evidence of heart failure was seen in 5.6%.
Table 3: Site of MI

Click here to view

Hemodynamic features and LV angiography

Mean LVEDP was 17.72 mmHg. LV end-diastolic and end-systolic volumes were mildly increased. LVEF was <50% in 30.3% patients. MR was seen in 10.5% and was mild in most the cases. The majority of patients (54.3%) were found to have moderate or large size MI (as estimated from LV angiogram) [Table 4].
Table 4: Coronary angiographic features

Click here to view

Coronary angiography

Coronary angiographic features are shown in [Table 3]. Significant CAD was seen in a high percentage (65%) with the majority (32.5%) having single-vessel CAD. Most patients with significant CAD had either one or two segments involved. However a good number of patients had more segments involved, with eight segments being the most extensive. Similarly distal vessel coronary artery disease was not uncommon, being documented in 33 patients. In those with involvement of multiple segments (three to eight segments), complex lesion anatomy was seen in 12 patients. Total occlusion of significant size vessel was seen in 44 patients. Total 26.5% of patients had proximal LAD segment involved. About half of the patients needed revascularization with PCI (32%) or CABG (13.5%) [Table 5].
Table 5: Treatment option

Click here to view

Coronary revascularization

Percutaneous coronary intervention

In patients undergoing PCI, the mean number of stents used was 1.3±0.67. The mean length of stents used was 20.3±12.6 mm and the mean diameter of the stents was 3.03±0.25mm.

Coronary artery bypass graft surgery

In patients undergoing CABG the mean number of grafts was 2.57±1.29 (range 1-5). And 47.6% needed three or more grafts and in 23.8% four or five grafts were used.

   Discussion Top

Peculiarities of CAD in the young

There is a special interest in studying CAD in the young due to the peculiarities in this subgroup. Studies have been done to evaluate CAD in the young as well as to compare it with CAD in an older age group. [6],[7],[9],[15] Younger patients have relatively lower prevalence of traditional risk factors such as diabetes mellitus, systemic hypertension, and hyperlipidemia. However, history of smoking and family history of early CAD are seen more commonly. [4],[15]

Risk factors

In agreement with earlier studies, we found a history of smoking to be the most important risk factor in 71% of the patients. Similarly family history of CAD was present in a high percentage of patients. A complex interplay of genetic and environmental factors in the presence of smoking is the most likely reason for the early manifestation of CAD in these patients.

Angiographic studies

Not much literature is available with respect to angiographic features in very young patients undergoing CAG, and when available they represent only a very small percentage of total population of young patients with CAD. Wolfe et al.[4] from the USA analyzed angiographic features in 35 patients who were <35 years of age (1.5% of the total number catheterized). They were compared with 100 patients ≥55 years of age. They found a very low prevalence of triple-vessel CAD in the first group (14.3%) as compared to 43% in the second group. In the study by Glover et al., [16] 120 consecutive patients 35 years or younger underwent coronary angiography following a clinical MI. Significant CAD was seen in 78% and the prevalence of triple-vessel CAD was 42%.

In an earlier article published from our center, we had studied 60 patients less than 35 years of age following a first MI. [8] Significant CAD was present in 73.3%. However triple-vessel CAD was seen only in 5%. In 25% there was involvement of more or equal to three coronary artery segments.

Chen et al.[11] from the United Kingdom analyzed the findings in 100 male patients with the clinical onset of disease at age ≤45 years. These were compared with the findings in 100 older male patients ≥60 years. Younger patients were found to have angiographically complex stenosis morphological features (59% vs 36%; p<0.01). At the same time, they had less extensive CAD (one vessel CAD in 54% vs 36%; p< 0.001). Triple-vessel disease was present in only 10% of the young patients.

Wei et al.[25] from Boston compared young men and women with MI and noted atherosclerosis to be more advanced and accounting for most MIs in men and less so in women. The prevalence of normal coronaries, atherosclerotic CAD, and nonatherosclerosis causes of MI in young patients have varied in different studies. [9],[14],[17],[23],[24],[26],[27]

Implication of angiographic findings from the present study

LVEF <50% was seen in above a third of our patients. LV dysfunction in this young age would definitely affect the long-term prognosis. When compared to our earlier study on very young patients [8] and published in 1999, the percentage of triple-vessel disease has increased from 5% to 12.5% and that of single-vessel disease has decreased from 46.7% to 32.3%. In the present study involvement of ≥4 segments was seen in 20.8% patients as compared to only 11.4 % in our earlier study. Whether these differences represent a more aggressive disease in the later years is not clear.

Uniqueness of this study

We have studied very young Asians from the Arab and Indian subcontinent backgrounds. Cut-off age of ≤35 years years represents very young patients. We used the number of diseased vessels involved (one-, two-, three vessel or left main) to assess the severity of CAD. We have done more detailed analysis of the angiographic features.

Limitations of the study

We have not done a detailed analysis of the various lipoprotein subfractions. Analysis of the lipoprotein subfractions including Lp(a) would throw more light on the pathogenesis of premature CAD in our patients. We also could not do any genetic studies. As in many other studies we have used eye-balling to grade angiographic stenosis. It could be argued that a more objective quantitative analysis would yield more accurate results.

The future scope

We live in an age where there is a global rise in the prevalence of manifest CAD. This is occurring even in developing countries and is affecting a significant number of people at a younger age. There is an urgent need to study this subject at greater depth and come out with adequate preventive and therapeutic measures before it is too late.

   Acknowledgments Top

We appreciate the technical help we received from our Cardiac Catheterization laboratory staff, both radiology technicians and nursing staff. Also we acknowledge the secretarial help from Shahid Khan and his colleagues.

   References Top

1.Fournier JA, Sanches A, Quero J, Perez Cortacero JA, Gonzales BA. Myocardial infarction in men aged 40 years or less: prospective clinical - angiographic study. Clin Cardiol 1996;19:631-6.   Back to cited text no. 1
2.Cole JH, Sperling LS. Premature Coronary artery disease: Clinical risk factors and prognosis. Curr Atheroscler Rep 2004;6:121-5.   Back to cited text no. 2
3.Imazio M, Bobbio M, Bergerone S, Barlera S, Maggioni AP. Clinical and epidemiological characteristics of juvenile myocardial infarction in Italy: The GISSI experience. G Ital Cardiol 1998;28:505-12.   Back to cited text no. 3
4.Wolfe AM, Vacek JL. Myocardial Infarction in the young. Chest 1988;94:926-30.   Back to cited text no. 4
5.Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, et al. Acute myocardial infarction in the young - The University of Michigan experience. Am Heart J 2002;143:56-62.   Back to cited text no. 5
6.Woon VC, Lim KH. Acute myocardial infarction in the elderly - the differences compared with the young. Singapore Med J 2003;44:414-8.  Back to cited text no. 6
7.Jalowiel DA, Hill JA. Myocardial infarction in the young and in women. Cardiovasc Clin 1989;20:197-206.   Back to cited text no. 7
8.Thomas CS, Cherian G, Abraham MT, Hayat NJ, Lulu AR, Bisharatullah MS, et al. Patients under 35 years with a first Q wave acute myocardial infarction. Int J Cardiol 1999;69:263-70   Back to cited text no. 8
9.Choudhury L, Marsh JD. Myocardial Infarction in Young Patients. Am J Med 1999;107:254-61.   Back to cited text no. 9
10.Vardan S, Mookherjee S, Vardan S, Sinha AK. Special Features of coronary heart disease in people of the Indian sub-continent. Indian Heart J 1995;47:399-407.   Back to cited text no. 10
11.Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 195;18:364-69.   Back to cited text no. 11
12.Mocetti T, Malacrida R, Pasotti E, Sessa F, Genoni M, Bariera S, et al. Epidemiologic variables and outcomes in 1972 young patiens with acute myocardial infarction: Data from GISSI 2 data base. Arch Intern Med 1997;157:865-9.   Back to cited text no. 12
13.Gotsman I, Lotan C, Mosseri M. Clinical manifestations and outcome of acute myocardial infarction in very young patients. Isr Med Assoc J 2003;5:633-6.   Back to cited text no. 13
14.Klein LW, Agarwal JB, Herlich MB. Prognosis of symptomatic coronary artery disease in young adults aged 40 years or less. Am J Cardiol 1987;60:1267-72.  Back to cited text no. 14
15.Cole JH, Miller JI, Sperling LS, Weintraub WS. Long term follow up of coronary artery disease presenting in young adults. J Am Coll Cardiol 2003;41:521-8.   Back to cited text no. 15
16.Glover MU, Kuber MT, Warren SE, Vieweg WV. Myocardial infarction before age 36: Risk factor and arteriographic analysis. Am J Cardiol 1982;49:1600-3.  Back to cited text no. 16
17.Tewari S, Kumar S, Kapoor A, Singh U, Agarwal A, Bharti BB, et al. Premature coronary artery disease in North India: an angiography study of 1971 patients. Indian Heart J 2005;57:311-8.  Back to cited text no. 17
18.Fournier JA, Cabezon S, Cavuela A, Ballesteros SM, Cortacero JA, Diaz dela LL. Long term prognosis of patients having acute myocardial infarction when ≤ 40 years of age. Am J Cardiol 2004;94:989-92.   Back to cited text no. 18
19.Stone GW, Ligon RW, Rutherford BD, McConahay DR, Hartzler GO. Short term outcome and long term follow up following coronary angioplasty in the young patient, An 8-year experience. Am Heart J 1989;118:873-7.  Back to cited text no. 19
20.Kofflard M, de Jaegere P, Van Domburg R, Ruygrok P, Van den Brand, Serruys PW, et al. Immediate and long term clinical outcome of coronary angioplasty in patient aged 35 years or less. Br Heart J 1995;73:82-6.   Back to cited text no. 20
21.Lytle BW, Kramer JR, Golding LR, Cosgrove DM, Borsch JA, Goormastic M, et al. Young adults with coronary atherolsclerosis: 10 year result of surgical myocardial revascularization. J Am Coll Cardiol 1984;4:445-53.   Back to cited text no. 21
22.Fitz Gibbon GM, Hamilton MG, Leach AJ, Kafka HP, Markle HV, Keon WJ. Coronary artery disease and coronary bypass grafting in young men: Experience with 138 subjects 39 years of age and younger. J Am Coll Cardiol 1987;9:977-88.   Back to cited text no. 22
23.Cohen DJ, Basamania C, Graeber GM, Deshong JL, Burge JR. Coronary artery bypasses grafting in young patients under 36 years of age. Chest 1986;89:811-6.   Back to cited text no. 23
24.Ng WK, Vedder M, Whitlock RM, Milsom FP, Nisbet HD, Smith WM, et al. Coronary revascularization in young adults. Eur J Cardiothoracic Surg 1997;11:732-8.   Back to cited text no. 24
25.Wei JY, Bulkley BH. Myocardial infarction before age 36 years in women: Predominance of apparent non atherosclerotic events. Am Heart J 1982;104:561-6.  Back to cited text no. 25
26.Culic V, Miric D, Jukic I. Acute myocardial infarction: Differing preinfarction and clinical features according to infarct size and gender. Int J Cardiol 2003;90:189-96.   Back to cited text no. 26
27.Hayat N, Mohammed M, Simo M. Coronary Artery Disease in Patients aged 30 and younger. Jap Heart J 1986;27:679-84.  Back to cited text no. 27


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]

This article has been cited by
1 Cardiovascular Profiles of Younger and Older Coronary Artery Disease Patients in Asian and Western Regions
Siao Suan Cheong, Kok Yong Chin, Azizah Ugusman, Amilia Aminuddin
Current Epidemiology Reports. 2023;
[Pubmed] | [DOI]
2 Evaluation of Risk Factors of Premature Coronary Artery Disease in Patients From North India: A Rising Epidemic
Gautam Kumar Bunker, Manoj Patidar, Devendra Atal, Ratti Lal Meena
Indian Journal of Clinical Cardiology. 2022; : 2632463622
[Pubmed] | [DOI]
3 Combined effect of hyperhomocysteinemia and smoking on the severity of coronary artery disease in young adults?=?35 years of age: a hospital-based observational study
Jiayin Sun, Wei Han, Sijing Wu, Shuo Jia, Zhenxian Yan, Yonghe Guo, Yingxin Zhao, Yujie Zhou, Xiaoli Liu
BMC Cardiovascular Disorders. 2021; 21(1)
[Pubmed] | [DOI]
4 Gender Differences in South Indians with Premature Coronary Artery Disease (< 40 Years)—Insights from the PCAD Registry
Laxmi H. Shetty, Rahul S. Patil, Jayashree Kharge, J. R. Vijay Kumar, Santu Ghosh, C. N. Manjunath
Indian Journal of Cardiovascular Disease in Women - WINCARS. 2021; 06(03): 176
[Pubmed] | [DOI]
Saroj Mandal, Vignesh. R, Sidnath Singh
[Pubmed] | [DOI]
6 Clinical profile & long-term natural history of symptomatic coronary artery disease in young patients (<30 yr)
Arun Gopalakrishnan,Harikrishnan Sivadasanpillai,Sanjay Ganapathi,KrishnaKumar Mohanan Nair,Sivasankaran Sivasubramonian,Ajitkumar Valaparambil
Indian Journal of Medical Research. 2020; 152(3): 263
[Pubmed] | [DOI]
7 Demographic & angiographic profile of young patients aged 40 year & less undergoing coronary angiography in a tier II city of Eastern India
Binayendu Prakash,Anurag Jaiswal,MandarM Shah
Journal of Family Medicine and Primary Care. 2020; 9(10): 5183
[Pubmed] | [DOI]
8 Features of coronary artery patterns and percutaneous coronary intervention in patients with acute coronary syndrome and stable angina in patients aged below 40 years
F Z Abdullaev,N M Babaev,L S Shikhieva
Kazan medical journal. 2020; 101(1): 18
[Pubmed] | [DOI]
9 Risk factor profile in young adults with early coronary artery disease and abdominal obesity
Yu. I. Ragino,N. A. Kuzminykh,V. I. Oblaukhova,V. S. Shramko,D. V. Denisova,L. V. Shcherbakova
Complex Issues of Cardiovascular Diseases. 2020; 9(2): 64
[Pubmed] | [DOI]
10 Profile of coronary artery disease in indian rural youth (< 35 yrs)
Rahul S. Patil,Laxmi H. Shetty,Shanmugam Krishnan,Anindya Sundar Trivedi,T.R. Raghu,C.N. Manjunath
Indian Heart Journal. 2020; 72(5): 394
[Pubmed] | [DOI]
11 Prevalence of coronary heart disease (by epidemiological criteria) and its association with lipid and non-lipid risk factors in the Novosibirsk population of 25-45 years
Yu. I. Ragino,N. A. Kuzminykh,L. V. Shcherbakova,D. V. Denisova,V. S. Shramko,M. I. Voevoda
Russian Journal of Cardiology. 2019; (6): 78
[Pubmed] | [DOI]
12 Lipoprotein(a): An underrecognized genetic risk factor for malignant coronary artery disease in young Indians
Enas A. Enas,Basil Varkey,T.S. Dharmarajan,Guillaume Pare,Vinay K. Bahl
Indian Heart Journal. 2019; 71(3): 184
[Pubmed] | [DOI]
13 Premenopausal cardiovascular disease and age at natural menopause: a pooled analysis of over 170,000 women
Dongshan Zhu,Hsin-Fang Chung,Nirmala Pandeya,Annette J. Dobson,Rebecca Hardy,Diana Kuh,Eric J. Brunner,Fiona Bruinsma,Graham G. Giles,Panayotes Demakakos,Jung Su Lee,Hideki Mizunuma,Kunihiko Hayashi,Hans-Olov Adami,Elisabete Weiderpass,Gita D. Mishra
European Journal of Epidemiology. 2019; 34(3): 235
[Pubmed] | [DOI]
14 The Young Myocardial Infarction Study of the Western Indians: YOUTH Registry
Anand N. Shukla,Ashwal A. Jayaram,Dhaval Doshi,Priyanka Patel,Komal Shah,Alok Shinde,Harsh Ghoniya,Karthik Natarajan,Tarun Bansal
Global Heart. 2019; 14(1): 27
[Pubmed] | [DOI]
15 Gençlerde Revaskülarizasyon Gerektiren Koroner Arter Hastaligi Risk Faktörleri ve Anjiyografik Özellikleri: Tek Merkez Deneyimi
Flora Özkalayci,Öykü Gülmez,Armagan Altun
Balikesir Medical Journal. 2019; : 59
[Pubmed] | [DOI]
16 Multivessel Coronary Artery Disease in Diabetes Mellitus Patients
Amanj Kamal Mohammed
Kurdistan Journal of Applied Research. 2019; 4(2): 121
[Pubmed] | [DOI]
17 Premature Coronary Heart Disease in South Asians: Burden and Determinants
Sarah T. Ahmed,Hasan Rehman,Julia M. Akeroyd,Mahboob Alam,Tina Shah,Ankur Kalra,Salim S. Virani
Current Atherosclerosis Reports. 2018; 20(1)
[Pubmed] | [DOI]
18 Risk Factors among Young Saudi Male Patients who underwent Coronary Revascularization (PCI or CABG)
Journal of Cardiology & Current Research. 2017; 9(3)
[Pubmed] | [DOI]
19 AMI in very young (aged =35years) Bangladeshi patients: Risk factors & coronary angiographic profile
Fazila-Tun-Nesa Malik,Md. Kalimuddin,Nazir Ahmed,Mohammad Badiuzzzaman,Mir Nesaruddin Ahmed,Ashok Dutta,Dhiman Banik,Md. Kabiruzzaman,Habibur Rahman,Tawfiq Shahriar Huq,Md. Farhad Jamal
Clinical Trials and Regulatory Science in Cardiology. 2016; 13: 1
[Pubmed] | [DOI]
20 The complex of risk predictors and coronary artery patterns with volume of surgical and endovascular myocardial revascularization in adults younger 35—40 years with acute coronary syndrome and stable angina
F. Z. Abdullayev,R. M. Makhmudov,I. M. Bagirov,E. F. Abbasov,I. D. Geybatov,L. S. Shikhiyeva,N. J. Kazimzade
Kardiologiya i serdechno-sosudistaya khirurgiya. 2016; 9(3): 13
[Pubmed] | [DOI]
21 Differing Clinical Characteristics Between Young and Older Patients Presenting with Myocardial Infarction
Kyriakos Matsis,Ana Holley,Ali Al-sinan,Phillip Matsis,Peter D Larsen,Scott A Harding
Heart, Lung and Circulation. 2016;
[Pubmed] | [DOI]
22 Risk factors for coronary artery disease and acute coronary syndrome in patients =40 years old
Hassan Alkhawam,Robert Sogomonian,Mohammed El-Hunjul,Mohamad Kabach,Umer Syed,Neil Vyas,Sumair Ahmad,Timothy J Vittorio
Future Cardiology. 2016;
[Pubmed] | [DOI]
Parsa Mani Mekhala,Deva Sumanth Kumar,Lingam Aruna,Perada Vasavi,V. Vijay Sreedhar
Journal of Evidence Based Medicine and Healthcare. 2016; 3(62): 3359
[Pubmed] | [DOI]
24 Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq
Ameen Mosa Mohammad,Hekmat Izzat Jehangeer,Sabri Khalif Shaikhow
BMC Cardiovascular Disorders. 2015; 15(1)
[Pubmed] | [DOI]
25 Towards excellence in cardiac surgery: experience from a developing country
Aamir Saifuddin,Syed Shahabuddin,Shazia Perveen,Shumaila Furnaz,Hasanat Sharif
International Journal for Quality in Health Care. 2015; 27(4): 255
[Pubmed] | [DOI]
26 Coronary Artery Disease in Young Adults
Hassan Alkhawam,Feras Zaiem,Robert Sogomonian,Mohammed El-Hunjul,Mohamad Al-kateb,M. Umair Bakhsh,Raef Madanieh
The American Journal of the Medical Sciences. 2015; 350(6): 479
[Pubmed] | [DOI]
27 Features of ischemic heart disease and myocardial revascularization in patients younger than 40 years
F. Z. Abdullaev,V. Sh. Mamedov,I. M. Bagirov,I. D. Geybatov,L. S. Shikhieva,N. Dzh Kazimzade
Kardiologiya i serdechno-sosudistaya khirurgiya. 2015; 8(2): 21
[Pubmed] | [DOI]
28 What are the Predictors of Coronary Artery Disease in Young Saudi Arabian Patients
Mohammed Balghith
Journal of Cardiology & Current Research. 2015; 4(2)
[Pubmed] | [DOI]
29 Obesity and Coronary Artery Disease: Evaluation and Treatment
David Garcia-Labbé,Emmeline Ruka,Olivier F. Bertrand,Pierre Voisine,Olivier Costerousse,Paul Poirier
Canadian Journal of Cardiology. 2014;
[Pubmed] | [DOI]
30 Coronary artery disease in Iranian young adults, similarities and differences
Mahnoosh Foroughi,Sorena Abbaszadehahranjani,Mazaher Ebrahimian,Mahdieh Saieedi,Morteza Safi,Zahra Abtahian
Open Journal of Epidemiology. 2014; 04(01): 19
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
    Patients and Methods
    Article Tables

 Article Access Statistics
    PDF Downloaded411    
    Comments [Add]    
    Cited by others 30    

Recommend this journal