Premature coronary artery disease

Premature coronary artery disease Premature coronary artery disease (CAD) a rare condition (6% of all acute coronary syndromes). Compared with CAD in, it is characterized by a more predominant male gender (90%) and a higher prevalence of smoking (80 to 90%), family history of CAD (50%) and triggers of myocardial infarction such as intense physical exertion (20%). Young CAD patients show less severe coronary atherosclerosis (60% have single vessel lesions and 14% have normal coronary angiography) and a more a higher incidence of ST-elevation myocardial infarction (80%) underlying the importance of acute coronary thrombosis. It has been proven that altered fibrin architecture in this population is responsible for hypofibrinolysis and that it is an independent predictor of premature CAD. Long term prognosis of young CAD patients is better than that of older CAD patients but remains worrisome (the mortality rate is 25% at 15 years and the recurrence of major adverse cardiac events is 12% at 8 years). Therefore, active secondary prevention is required in this population.