Premature Coronary Artery Disease in Young Male Patient with Strong Family History

Dea Arie Kurniawan, Mohammad Saifur Rohman, Anna Fuji Rahimah, Budi Satrijo

Abstract


BACKGROUND: Coronary artery disease (CAD) occurring in less than 45 years of age is termed as premature CAD (PCAD). Recent studies showed a prevalence of 4-10 % of PCAD. PCAD is associated with unfavorable outcomes for the patients and had a greater impact on the quality of life. Family History is the best method to explained complex interaction between shared risk factor.

CASE ILLUSTRATION: A 37-years old male admitted to Saiful Anwar Hospital for further evaluation of anginal pain. The patient complains of recurrent chest pain since 5 months ago but still relieved by rest. The electrocardiogram showed Wellens Type B which is specific for critical stenosis of the left anterior descending artery (LAD). Then the patient undergoing DCA Ad Hoc. The implantation of a 46 mm DES at proximal until distal LAD was performed. The patient discharged after a day observation.

DISCUSSION: The challenging point, in this case, was it happen at a young age with strong family history. There was positive family history of PCAD in 1st degree relative on her brother and mother, despite several risk factors were identified in this case consist of smoking, and dyslipidemia, which make CAD risk higher. Despite adequate control of risk factors, family screening is important to reveal subclinical atherosclerosis.

CONCLUSION: Approach to a patient with PCAD comprises of management of traditional risk factors and careful investigation of Family History. Individual with positive family history of PCAD should be treated more cautiously

Keywords


Premature coronary artery disease, young male, risk factor

Full Text:

PDF

References


Ohira T, Iso H. Cardiovascular Disease Epidemiology in Asia: An Overview. Circulation Journal. 2013;77(7):1646-52.

Hussain MA, Al Mamun A, Peters SA, Woodward M, Huxley RR. The Burden of Cardiovascular Disease Attributable to Major Modifiable Risk Factors in Indonesia. J Epidemiol. 2016;26(10):515-21.

Rubin JB, Borden WB. Coronary Heart Disease in Young Adults. Current Atherosclerosis Reports. 2012;14(2):140-9.

Poorzand H, Tsarouhas K, Hozhabrossadati SA, Khorrampazhouh N, Bondarsahebi Y, Bacopoulou F, et al. Risk factors of Premature Coronary Artery Disease in Iran: A Systematic Review and Meta‐analysis. European journal of clinical investigation. 2019;49(7):e13124.

Baransyah L, Rohman MS, Suharsono T. Faktor-Faktor yang Berpengaruh terhadap Kejadian Gagal Jantung pada Pasien Infark Miokard Akut di Rumah Sakit dr. Saiful Anwar Malang. Majalah Kesehatan FKUB. 2014;1(4):209-13.

Bachmann JM, Willis BL, Ayers CR, Khera A, Berry JD. Association between family history and coronary heart disease death across long-term follow-up in men: the Cooper Center Longitudinal Study. Circulation. 2012;125(25):3092-8.

Eaton CB, Bostom AG, Yanek L, Laurino JP, McQuade W, Hume A, et al. Family History and Premature Coronary Heart Disease. The Journal of the American Board of Family Practice. 1996;9(5):312.

Ahmadi SH, Abbasi SH, Ugurlucan M, Bina P. Positive family history as the single traditional risk factor for developing extensive very premature coronary artery disease: a case report. J Tehran Heart Cent. 2013;8(1):54-7.

Abderrahman HA, Al-Abdallat IM, Idhair AK. Age Threshold for Proper Definition of Premature Coronary Artery Disease in Males. Journal of Forensic Legal Medicine. 2018;58:45-9.

Berry JD, Lloyd-Jones DM, Garside DB, Greenland P. Framingham risk score and prediction of coronary heart disease death in young men. Am Heart J. 2007;154(1):80-6.

Celik T, Iyisoy A. Premature Coronary Artery Disease in Young Patients: An Uncommon But Growing Entity. International journal of cardiology. 2010;144(1):131-2.

Aggarwal A, Srivastava S, Velmurugan M. Newer Perspectives of Coronary Artery Disease in Young. World Journal of Cardiology. 2016;8(12):728.

Stitziel NO, MacRae CA. A Clinical Approach to Inherited Premature Coronary Artery Disease. Circulation: Cardiovascular Genetics. 2014;7(4):558-64.

Christiansen MK. Early-onset Coronary Artery Disease Clinical and Hereditary Aspects. Dan Med J. 2017;64(9).

Nasir K, Budoff M, Wong N, Scheuner M, Herrington D, Arnett D. Family history of premature coronary heart disease and coronary artery calcification - Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2007;116:619-26.

Kim C, Chang H-J, Cho I, Sung JM, Choi D, Jeong MH, et al. Impact of family history on the presentation and clinical outcomes of coronary heart disease: data from the Korea Acute Myocardial Infarction Registry. Korean J Intern Med. 2013;28(5):547-56.

Aggarwal A, Aggarwal S, Sarkar PG, Sharma V. Predisposing Factors to Premature Coronary Artery Disease in Young (Age ≤ 45 Years) Smokers: A Single Center Retrospective Case Control Study From India. J Cardiovasc Thorac Res. 2014;6(1):15-9.

Wiesbauer F, Blessberger H, Azar D, Goliasch G, Wagner O, Gerhold L, et al. Familial-combined hyperlipidaemia in very young myocardial infarction survivors (≤ 40 years of age). European Heart Journal. 2009;30(9):1073-9.




DOI: https://doi.org/10.21776/ub.hsj.2022.003.01.8

Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 Dea Arie Kurniawan, Mohammad Saifur Rohman

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.