Normotensive young patients with acute coronary syndrome: Etiological factors and differences in the development of critical coronary lesion.

Background: Acute coronary syndrome (ACS) is a leading cause of mortality worldwide, especially among young males. While the incidence of ACS decreases in older populations, it remains significant in younger individuals. This study aimed to identify clinical and biochemical differences between young ACS patients with critical atherosclerotic stenoses and those without.

Methods: The study retrospectively analyzed 55 normotensive patients aged 18-35 years diagnosed with ACS between January 2023 and January 2024. Patients were categorized as "critical" (≥70% stenosis) or "noncritical". Demographic, etiological, and biochemical parameters were compared.

Results: Critical coronary lesions were found in 32 patients (58%). Active smoking was significantly more common in the critical group (p = 0.048), and mean MPV was lower (p = 0.024). Logistic regression identified male gender (p = 0.026), CRP (p = 0.010), GGT (p = 0.021), and interventricular septum thickness (p = 0.043) as risk factors.

Conclusion: This study underscores the importance of early detection and intervention in young ACS patients, particularly in addressing modifiable risk factors like smoking, inflammation, and oxidative stress. Further studies are needed to validate these findings.