Comparative Analysis of Angiographic Characteristics in Acute Coronary Syndrome Among Patients Below 40 and Above 60 Years of Age
Abstract
Introduction: Acute Coronary Syndrome (ACS) is a significant cause of morbidity and mortality globally with differing risk profiles and pathophysiological mechanisms across age groups. Objectives: To compare the angiographic characteristics of coronary artery involvement in patients diagnosed with ACS in two distinct age groups: those aged <40 years and those aged >60 years. Methods: This analytical cross-sectional study was conducted over 18 months, from March 1, 2023 to August 31, 2024at the Department of Cardiology, Nilratan Sircar Medical College and Hospital, Kolkata. The study population comprised adult patients below 40 years and above 60 years of age admitted with acute coronary syndrome. Results: In this study of 192 Acute Coronary Syndrome (ACS) patients, two age groups were compared: those below 40 years and those above 60 years. Younger patients showed a marked male predominance (84%), whereas the elderly group had a more balanced gender distribution. The mean TIMI score was significantly higher in older patients (3.56± 1.51) compared to the younger group (2.87 ± 1.69), indicating a greater risk profile in the elderly. Single-vessel disease was most common in the younger cohort (69%), while older patients had a higher prevalence of triple-vessel disease (29%). The left anterior descending artery (LAD) was the most frequently involved vessel across both groups, with higher involvement in the elderly. Additionally, left main coronary artery (LMCA) dis-ease was significantly more common in older patients (29% vs. 11%). SYNTAX II scores further supported these findings, with younger patients more often falling into the low-risk category, whereas a significant portion of older patients had intermediate to high scores. Conclusion: Younger ACS patients tend to have less extensive but more thrombotic coronary involvement, often limited to a single vessel, with modifiable lifestyle-related risk factors predominating. Older patients, however, typically present with diffuse, multi-vessel atherosclerotic disease, correlating with higher rates of comorbidities. These findings underscore the need for age-specific preventive and interventional strategies in the management of ACS.Keywords:
Acute Coronary Syndrome, Coronary Angiography, Young ACS, Elderly ACS, Coronary Artery Disease, Risk Factors, Single Vessel Disease, Multi Vessel DiseaseReferences
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