ACUTE CORONARY SYNDROME IN YOUNG ADULTS: CLINICAL PROFILE, CARDIOVASCULAR RISK FACTORS, AND SHORT-TERM IN-HOSPITAL OUTCOMES AT AYUB TEACHING HOSPITAL

Abstract

Background: Acute coronary syndrome (ACS) is increasingly recognized among young adults and is associated with substantial morbidity and socioeconomic consequences. Data regarding the clinical profile, cardiovascular risk factors, and short-term outcomes of young ACS patients in northern Pakistan remain limited. This study aimed to describe the demographic characteristics, cardiovascular risk factors, clinical spectrum, and short-term in-hospital outcomes of young adults presenting with ACS at Ayub Teaching Hospital Abbottabad.
Methods: A descriptive cross-sectional hospital-based study was conducted in the Departments of Cardiology and General Medicine at Ayub Teaching Hospital Abbottabad from 1 April 2026 to 5 June 2026. A total of 100 consecutive patients aged 18–45 years admitted with ACS, including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA), were enrolled. Data regarding demographic characteristics, clinical presentation, cardiovascular risk factors, ACS subtype, investigations, management, complications, and short-term in-hospital outcomes were collected using a structured proforma and analyzed using SPSS version 26.
Results: Among 100 patients, the mean age was 38.2 ± 5.6 years, and 78.0% were male. The majority (66.0%) belonged to the 36–45-year age group, while 61.0% were from rural areas. Chest pain was the most common presenting symptom (94.0%), followed by sweating (71.0%) and shortness of breath (39.0%). The most prevalent cardiovascular risk factors were smoking/tobacco use (63.0%), dyslipidemia (49.0%), sedentary lifestyle (46.0%), hypertension (42.0%), and diabetes mellitus (31.0%). STEMI was the predominant ACS subtype (64.0%), followed by NSTEMI (24.0%) and UA (12.0%). Elevated troponin-I was observed in 88.0% of patients, while regional wall motion abnormalities were present in 67.0%. The mean left ventricular ejection fraction was 45.8 ± 8.7%. Coronary angiography was performed in 38.0% of patients, among whom single-vessel disease was identified in 50.0%. Arrhythmias (16.0%) and acute heart failure (13.0%) were the most common in-hospital complications. Overall, 90.0% of patients improved and were discharged, whereas 2.0% died during hospitalization.
Conclusion: ACS in young adults was characterized by a predominance of male patients, a high burden of modifiable cardiovascular risk factors, and frequent presentation as STEMI. Smoking, dyslipidemia, hypertension, diabetes mellitus, and sedentary lifestyle were common risk factors. Despite the occurrence of in-hospital complications, most patients experienced favorable short-term outcomes, highlighting the importance of early risk-factor modification and timely evidence-based management in this population.