Differences in Clinical Nature and Outcome Among Youth and Older Patients Suffering from an Acute Coronary Syndrome

Abstract Objective: Acute coronary disease (ACS) is an acute regional reduction in coronary blood flow. Pathophysiology, clinical appearance, risk factors and clinical outcomes may vary between younger and older patients. The purpose of this study was to assess these factors in patients less than 45 years of age compared to older adults admitted with a ACS diagnosis.Patients and methods: Retrospective chart review study of ACS patients admitted between 2015 and 2020. Results: Overall, 652 patients were enrolled. Of these, 109 patients (16.7%) were under 45, with a mean age of 38 ± 7. Younger patients showed a higher rate of palpitation (23.9% versus. 13.6%; P = 0.019). A positive smoking history and a family history of CAD were seen more often in younger patients (42.2% vs. 27.3%, P < 0.001; 22.9% vs. 9.4%, P < 0.001, respectively). Older patients had greater renal impairment with higher creatinine (median = 1.10 mg /dl (range, 0.3-13.0) vs. 1.0 (0.3-19.0; p = 0. 001), BUN (median = 16.0 (mange, 0.9-141.0) vs 12.0 (0.9-49.0); P < 0.001)).Younger patients had higher levels of LDL and total cholesterol (median 138c. 115; p < 0.001) and cholesterol (median 209 vs. 178.5; p < 0.001). Hospital mortality was 0.9% in younger patients versus 7.4% in older patients (P=0.004). Conclusion: Palpitations, smoking, family history, higher LDL levels, and total cholesterol levels were more prevalent in adults younger than 45 years old with ACS. Impaired renal function, hypertension, and diabetes were more in older patients with ACS.