Acute Coronary Syndrome with Persistent St-Segment Elevation in Young Subjects Under 40 Years Old: About 17 Cases at The Montlucon Hospital Center
KAZIGA Wiyaou Dieu-Donné, SAMOURA Sana, SODOU Laou-Abalo, IRAKOZE Jean-Bertrand, AFASSINOU Yaovi Mignazonzon, PESSINABA Soulemane, PIO Machihude, DIALLO Nouhoum, CHANSEAUME Sylvain
Introduction: Atherosclerosis is a dynamic process that begins in early childhood and progresses slowly, making acute coronary syndrome an unusual entity in young subjects. The aim of this study is to investigate the epidemiological, clinical, electrical, and angiocoronarographic features of acute coronary syndrome with persistent ST-segment elevation myocardial infarction (STEMI) in young subjects.
Materials and Methods: We conducted a cross-sectional, retrospective, single-center, descriptive, and analytical study over a period of 5 years from January 1, 2019, to December 31, 2023. Patients of both sexes and aged less than 40 years admitted for acute coronary syndrome with persistent ST-segment elevation were included in our study.
Results: The prevalence of STEMI was 17/374 (4.5%) with a sex ratio (M/W) of 2.4. The mean age of the patients was 36.7 ± 3.8 years (men = 37.3 ± 3.6 years; women = 35.4 ± 4.2 years). Cardiovascular risk factors were dominated by active smoking (82.3%), coronary heredity (58.8%), and overweight (41.2%). None of our patients had diabetes. Chest pain was typical in 14/17 (82.3%) patients. In 58.8% of cases, the culprit lesion was located on the proximal Left anterior descending artery (LAD), followed by the right coronary artery (RCA) and the circumflex artery (CX) in 5/17 (29.4%) and 2/17 (11.8%) cases respectively. Coronary lesions were monotruncular in most cases (12/17). The average hospital stay was 4.9 ± 2.7 days.
Conclusion: STEMI in young people under 40 years of age is much more common in males who smoke and have a coronary artery disease hereditary. The lesions are most often monotruncular, with excellent short-term prognosis. However, it is important to emphasize secondary prevention to limit complications of the dynamic process that is atherosclerosis.
