Screening for Premature Coronary Disease in Rural Australia

Haidar Al Saffar, Joseph Suttie

Background

Coronary artery disease (CAD) is a major disease burden worldwide highlighting the importance of early diagnosis and management. Of all patients suffering CAD, young patients (aged under 45) present a small but important subset requiring characterisation to prevent long term complications.

Objective

Describe the frequency, severity and clinical relevance of CAD in young patients.

Materials and methods

From a database of 1810 patients who underwent Computed Tomography Cardiac Angiography (CTCA) between Nov-2012 and Jan-2018, comparisons were made between patients aged under and over 45 years if they satisfied the selection criteria after achieving formal consent and ethical clearance. Young patients diagnosed with CAD using CTCA were then further characterised.

Results

The mean age of young patients was 37.8 who made up 9% of all patients investigated for CAD. The majority of those investigated were male (66%) in the 36-45 years category. 77% of young patients with diseased coronaries were male and 23% were female. Young patients with CAD made up 1.27% of the entire study population and had a lower Coronary Artery Calcium Score (CACS) (6) & lower number of plaqued coronary vessels (single and double vessel disease). The prevalence of CAD in young patients increased with age.

Future directions

Investigating the risk factor profile in young patients may yield potential preventative measures to implement in primary and secondary healthcare to lower prevalence rates benefiting patients and the healthcare system.