Risk factors to predict severity of coronary artery disease in young patients undergoing coronary artery bypass grafting: A retrospective observational study

Objective: The differing pattern of dyslipidemia combined with inherent insulin resistance and contribution from varying lifestyles makes Indians more vulnerable to coronary artery disease (CAD) at a younger age. Smoking and other forms of tobacco, dyslipidemia and hypertension are major risk factors in the young. Our aim of the study is to find out risk factors to predict severity of CAD in young patients undergoing coronary artery bypass surgery (CABG). Methods: Young patients below 45 years of age consecutively admitted at our hospital and undergoing CABG were included. Demographic data are collected and analyzed. All the risk factors for early coronary artery disease and its outcome and intraoperative and immediate postoperative complications are analyzed. Early outcome analysis was done at the end of 1 year and midterm analysis was done at the end of 5 years. All routine investigations, 2D-echocardiography, electrocardiogram, and chest X-ray were analyzed at regular intervals and when required in the follow-up period also. Results: We retrospectively evaluated 148 adult CAD patients aged ≤ 45 years, who underwent their first isolated CABG surgery at our institute. We observed that smoking was the most common risk factor followed by hypertension, altered lipid profile and diabetes. Family history of CAD and obesity were also noted in 32.4% and 21.6% of patients. Conclusion: Our young surgical patients have a high frequency of risk factors such as smoking and dyslipidemia, hypertension and obesity which may lead to accelerated atherosclerosis and high frequency of 80% of multivessel disease in our cohort. Hypertension is the significant predictor of severe CAD in our cohort. High prevalence of CAD risk factors and LV dysfunction are associated with mortality in our cohort. Five-year survival in young Indian population after CABG is 91.8% with good functional class.. Prevention of risk factors is necessary to prevent CAD in young adults. Optimal secondary prevention with medications and strict adherence to lifestyle changes should be ensured to reduce future coronary events