title: Precocious virulent coronary atherosclerosis in the very young.
abstract: BACKGROUND
  The incidence of Myocardial Infarction (MI) in patients under the age of 30 has been rarely addressed. Moreover, it is not understood why these patients develop symptomatic Coronary Artery Disease (CAD) at such an early age. Traditional risk factor assessment has not been successful in identifying these patients before they present with MI.
  
  
  METHODS
  Retrospective, single cohort, observational study of 14,704 cardiac catheterizations performed in a community hospital between January 2006-January 2010 identified 12 cases age <30 with MI secondary to a fixed atherosclerotic lesion requiring angioplasty and stenting. The angiograms and charts were reviewed to assess the incidence and frequency of traditional risk factors such as smoking, dyslipidemia and diabetes and family history.
  
  
  RESULTS
  All the patients had single vessel disease. Many of the patients were noted to have traditional CAD risk factors. 2 patients had an intervention and then months later sustained another acute MI secondary to a new culprit lesion despite aggressive risk factor modification.
  
  
  CONCLUSIONS
  Evaluating patients for premature CAD by screening for traditional risk factors has not effectively identified at risk patients prior to presentation with MI. There is a role for studies evaluating new and novel risk factors and imaging modalities so that these patients can be identified prior to experiencing MI.
authors: Internal Medicine and Cardiology, JFK Medical Center, Miller School of Medicine, University of Miami, Atlantis, Florida, United States of America. bobchait@gmail.com
authors: Robert
authors: R
authors: Chait
authors: Rajesh
authors: R
authors: Ramineni
authors: Erin A
authors: EA
authors: Fender
mesh_terms: D000328:Adult; D017130:Angioplasty; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D055815:Young Adult