Coronary artery disease pattern in the young.

Ninety-two patients aged 40 years or less with documented coronary artery disease were studied with special emphasis on risk factors, coronary angiographic patterns and left ventricular function. Tobacco consumption was the most common risk factor (54%) followed by family history of coronary artery disease (40%). Hyperlipidaemia was not a frequent risk factor. Significant single vessel disease was present in 29% of patients. The incidence of double vessel and triple vessel disease was much higher. The left anterior descending artery was the most commonly involved vessel followed by right and circumflex coronary arteries. Left ventricular function as determined by ejection fraction was abnormal in 51% of patients; left ventricular end diastolic pressure was abnormal in 28% of patients. Sixty-eight percent of patients with no risk factors had either zero vessel or single vessel disease indicating a positive relationship between occurrence of risk factors and significant coronary artery disease in the young.