Acute Coronary Syndrome in Young Adults: The Thai ACS Registry

Background: There are few data regarding acute coronary syndrome (ACS) in young adults. ACS in young adults may have some characteristics that are different from those in older patients. Objective: The purpose of the present study was to assess the frequency, risk factors, presenting symptoms, treatment, complications and in-hospital outcomes of young patients with ACS in Thailand compared with those of older patients. Material and Method: From the Thai ACS registry database of 9,373 consecutive patients admitted to partici-pating hospitals between August 1, 2002 and October 31, 2005, the authors divided patients into three age categories: < 45 years, 45-54 years and> 54 years. Risk factors, presenting symptoms, type of ACS, manage-ment, complications and in-hospital outcomes of the 3 age groups were analyzed. Results: Young patients comprised of 5.8 % (544 patients) of all ACS patients. Discharge diagnosis in the young group was ST segment elevation myocardial infarction (STEMI) in 67%, non-ST segment elevation myocardial infarction (NSTEMI) 20 % and unstable angina 14%. The young patients were more likely to have an STEMI than their elder counterparts. Risk factors such as tobacco use and a family history were more frequent in the young patients, whereas diabetes and hypertension were less frequent. Importantly, 66 % of the patients aged <45 years had a history of tobacco use. A higher percentage of the young patients underwen