Unhealthy Lifestyle Only Partly to Blame for Heart Attack in Young Adults?

“Coronary artery disease is something young people need to be aware of,” said Laura Davidson, M.D., an internal medicine resident at Northwestern University in Chicago. “The lifestyle choices you make at a young age can absolutely impact you while you’re still young, not just 30 years down the line. They can catch up with you in a big way today.”

For the study, researchers analyzed the medical records of 124 consecutive patients under the age of 35 who were admitted to the hospital with ACS. All of the patients had coronary angiography at either Northwestern University or Vanderbilt University in Nashville, TN, and nearly half were treated with angioplasty and stenting.

The investigators found that 63% of patients had abnormal cholesterol levels, either too much LDL “bad” cholesterol (over 130 mg/dL) or too little HDL “good” cholesterol (under 40 mg/dL). In addition, nearly half of the patients (49%) were obese, 60% were smokers and 47% had high blood pressure.

Angiography revealed more signs of trouble. By threading a slender tube into the arteries of the heart and injecting x-ray dye, cardiologists were able to see blood clots in 43% of patients. Of these, 21% had a build-up of cholesterol plaque in one artery, while nearly half (48%) had plaque build-up in multiple arteries. However, in 30% of patients with blood clots, there was no angiographic evidence of coronary artery disease.

Dr. Davidson said that the message for patients is clear: Eat a healthy diet, stay active, and toss out the cigarettes. “It’s very important to stop smoking. It’s the number one thing you can do for your health,” she said.

The data could also spur new research and prevention strategies. The finding of blood clots even in coronary arteries with no plaque build-up suggests that some young patients may have a blood disorder that makes them especially prone to clotting, a condition known as hypercoagulability.

“We would like to do a prospective study of young patients who come in with ACS, and this time include hypercoagulation testing,” Dr. Davidson said. “If we could identify young patients at higher risk for ACS, it might lead to preventive treatments with new anti-clotting regimens.”

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