Risk Factor Profile and Clinical Characteristics of Acute Coronary Syndrome in Adults ≤45 Years: A Cross Sectional Study from Western India

Abstract

Background Young adults form a growing fraction of acute coronary syndrome (ACS) admissions in South Asia, yet granular data on their risk factor constellation remain sparse.

Methods We analysed prospectively collected data from 46 consecutive patients ≤45 years (mean 40.2 ± 4.0 y; 84.8 % men) admitted with STEMI, NSTEMI or unstable angina to a tertiary cardiac centre in Mumbai (2019 2021). Demographic, behavioural, anthropometric, biochemical and echocardiographic variables were recorded using a prespecified pro forma; associations with ACS phenotype were examined by χ²/Fisher tests (α = 0.05).

Results Half the cohort were active smokers and 54 % were obese (BMI ≥30 kg m⁻²). Hypertension and previously known diabetes were present in 24 % each, but HbA1c screening unmasked diabetes in an additional 30 %. High sensitivity CRP (hsCRP) >1 mg dl⁻¹ was seen in 83 % and was the only variable significantly associated with presentation type (STEMI/NSTEMI/UA, p < 0.001). Low HDL C (<40 mg dl⁻¹) affected 80 %, whereas LDL C was high in 57 %. Mean left ventricular ejection fraction was 45 ± 9 %.

Conclusion Young Indian ACS patients exhibit an adverse mix of modifiable risks—smoking, obesity, subclinical diabetes and systemic inflammation—underscoring the need for aggressive primordial prevention beginning in early adulthood.