title: Acute coronary syndrome in young adults from a Malaysian tertiary care centre.
abstract: OBJECTIVE
  Acute coronary syndrome (ACS) is one of the leading cause of morbidity and mortality worldwide. It is relatively uncommon in young adults as compared to the older population. Our objective was to assess the prevalence, demographic distribution, and risk factors for acute coronary syndrome (ACS) in patients less than 45 years of age admitted to a Malaysian tertiary care centre.
  
  
  METHODS
  This is a cross-sectional, retrospective, and single centre study with random sampling of the patients admitted for ACS to hospital from January 2005 to December 2013. Data were collected and analyzed. Patients less than 45 years of age were compared with patients more than 45 years of age.
  
  
  RESULTS
  A total of 628 patients were included in the study and with the prevalence of young ACS was 6.1% and mean age of 39±6 years. All the young ACS patients were diagnosed with unstable angina and non-ST elevation myocardial infarction (NSTEMI). Tobacco smoking and family history of coronary artery disease (CAD) were more frequent in young ACS. 59.5% of the young ACS patients were smokers, while 37.8% and 51.4% of them were found to suffer from diabetes mellitus and hypertension respectively. Tobacco smoking, diabetes mellitus, and hypertension had shown significant association with the onset of young ACS (p ≤ 0.05).
  
  
  CONCLUSIONS
  Three leading risk factors (tobacco smoking, diabetes mellitus, and hypertension) had been shown to be significantly associated with the onset of young ACS. Thus, it is important to identify this cohort and implement aggressive measures in tackling the risk factors in order to prevent or halt the development of coronary artery disease.
authors.affiliation: Dr. Fan Kee Hoo, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
authors.forename: Fan Kee
authors.initials: FK
authors.lastname: Hoo
authors.affiliation: Dr. Yoke Loong Foo, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
authors.forename: Yoke Loong
authors.initials: YL
authors.lastname: Foo
authors.affiliation: Dr. Sazlyna Mohd Sazlly Lim, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
authors.forename: Sazlyna Mohd Sazlly
authors.initials: SM
authors.lastname: Lim
authors.affiliation: Dr. Siew Mooi Ching, MMed(FM). Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
authors.forename: Siew Mooi
authors.initials: SM
authors.lastname: Ching
authors.affiliation: Dr. Boo Yang Liang, MRCP Hospital Enche' Besar Hajjah Khalsom, Jalan Kota Tinggi, 86000 Kluang, Johor, Malaysia.
authors.forename: Yang Liang
authors.initials: YL
authors.lastname: Boo
keywords: Acute coronary syndrome; Ischemic heart disease; Malaysia; Young adults