Young acute coronary syndrome outcomes in heterogenous Asians.

Background: Recently, more patients are presenting at a younger age with acute coronary syndrome (ACS). Objective: Identify the demographics, risk factors and outcomes of young ACS North of Kuala Lumpur, Malaysia. Materials and Methods: This was a prospective, observational study conducted in Sungai Buloh Hospital, North of Kuala Lumpur, Malaysia. Patients were enrolled during 2014 and 2015. Results: There was 1479 ACS, with a mean age of 56 ± 12. 10.6% (n=158) were below 40, with a mean age of 34 with the youngest at 17. Meanwhile 15.8% (n=25) were female. Ethnicity breakdown revealed 62% Malays, 24.1% Indians, 1.2% Chinese and 12.7% of other races. ACS subtypes showed 56.9% unstable angina (UA), 22.2% non-ST elevation myocardial infarction (NSTEMI) and 20.9% ST elevation myocardial infarction (STEMI). Cardiovascular risk factor assessment revealed 46.2% hypertension, 43.0% smokers, 6.3% ex-smokers, 29.7% known ischemic heart disease (IHD), 24.7% diabetes mellitus, 22.8% dyslipidemia, 19.0% positive family history of IHD and 10.8% alcohol consumption. Biochemical analysis showed fasting glucose level of 7.2 ± 3.5 mmol/L and serum creatinine 84.0 ± 23.5 μmol/L. Lipid profile revealed mean total cholesterol of 4.9 ± 1.4 mmol/L, triglyceride 2.2 ± 1.3 mmol/L, HDL 0.9 ± 0.4 mmol/L, and LDL of 3.3 ± 1.1 mmol/L. 30-day mortality was 3.2% while 90-day mortality was 4.5%. Conclusion: Majority of young ACS were male with positive risk factors such as hypertension and cigarette smoking.