686 Coronary lesion distribution in young patient presenting with acute coronary syndrome. (8th December 2021)

• Record Type: Journal Article
• Authors: Franzino, Marco; Pistelli, Lorenzo; Parisi, Francesca; De Santis, Giulia Azzurra; Nicolò, Claudio; Andò, Giuseppe; Virga, Vittorio; Vizzari, Giampiero; Saporito, Francesco; Carerj, Scipione; Di Bella, Gianluca; Micari, Antonio; Costa, Francesco
• Is Part Of: European heart journal supplements. Volume 23(2021)Supplement G
• Publication Date: 2021-12-08
• Subjects: Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suab140.023
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Aims: The distribution of coronary lesions in young patients presenting with acute coronary syndrome (ACS) is not known. Methods and results: We included 82 consecutive young patients (≤45 years at presentation) with ACS and obstructive coronary artery disease referred from October 2013 until March 2021 to our clinic. Significant coronary lesions (>50%) at each segment during coronary angiography were evaluated. A total of 158 lesions have been evaluated. Multivessel disease was observed in 37% of patients. Lesions at proximal and mid left anterior descending (LAD) coronary artery were the most common observation (Figure A). Roughly one in three lesions affected a proximal coronary segment (i.e. segment 1, 5, 6, or 11), and 45.1% of patients presented at least one lesion in these segments. Within each segment, lesions affected the ostium in 15.8%, proximal third in 26.8%, mid-third in 32.9%, and distal-third in 15.9% of cases. Among those presenting with ST-segment elevated myocardial infarction, culprit lesion distribution is presented in Figure B. Proximal segments were affected in 33.9%, while culprit lesion of the LAD, left circumflex, and right coronary artery was observed in 51.8%, 16.1%, and 32.1% respectively. Conclusions: In conclusion, coronary artery disease in patients presenting with ACS occur more often in the LAD and in proximal coronary segments. A significant lesion in a proximal coronary segment affected roughly half of young patients presenting with ACS.