Risk Factors for Acute Coronary Syndrome in Young Adults: A Hospital-Based Case–Control Study

Abstract

Background: Acute coronary syndrome (ACS) is increasingly reported in young adults, a group in whom the risk-factor profile and underlying mechanisms differ from those of older patients. Identifying the drivers of premature ACS is essential for targeted primary prevention.

Objective: To determine the prevalence and independent predictors of ACS among young adults aged ≤45 years compared with age- and sex-matched controls.

Methods: A hospital-based case–control study was conducted over 18 months. Two hundred consecutive patients aged 18–45 years admitted with a first ACS event were enrolled as cases, and 200 age- and sex-matched individuals without cardiovascular disease served as controls. Demographic data, behavioural habits, anthropometry, blood pressure, fasting lipid profile, and glycaemic status were recorded. Associations were assessed using the chi-square test and Student's t-test, and independent predictors were identified by multivariable logistic regression.

Results: Cases were predominantly male (78%) with a mean age of 39.4 ± 4.8 years. Current smoking (58% vs 24%), dyslipidaemia (61% vs 28%), a positive family history of premature coronary artery disease (34% vs 12%), hypertension (32% vs 17%), and diabetes mellitus (23% vs 11%) were significantly more frequent among cases (all P < 0.05). On multivariable analysis, smoking (adjusted OR 3.9), dyslipidaemia (aOR 3.1), family history (aOR 2.8), and central obesity (aOR 2.2) emerged as independent predictors.

Conclusion: Modifiable behavioural and metabolic factors—chiefly smoking, dyslipidaemia, and central obesity—dominate the risk profile of young adults with ACS. Aggressive tobacco control and early metabolic screening in this population are warranted