Assessment of risk factors, risk predictors, and trigger factors for the development of acute coronary syndrome in patients between 18-45 years of age- an observational, cross-sectional single center study

Acute coronary syndrome (ACS) refers to a range of clinical presentations almost always associated with rupture of an atherosclerotic plaque in a coronary artery with subsequent partial or complete thrombosis.The syndrome includes unstable angina (UA), non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). It is reported that individuals from Indian subcontinent may develop coronary artery disease (CAD) at a higher rate and at an early age. Onset of CAD before 40 y of age is considered as premature CAD.Although majority of studies reported that only about 3% of all CAD cases occur in <40 y of age, it should be considered as the ‘tip of the iceberg’ as young, asymptomatic patients usually do not undergo medical investigations.

The Objective of the study is to assess different risk factors for the development of ACS, trigger factors and  risk predictors for cardiovascular events like ACS.

Patient reporting to the Emergency Department and has been diagnosed with ACS by Cardiologist and if they fit the eligibility criteria, will be included in the study. As per SOC, all necessary investigations will be performed along with required treatment and once the patient is stabilize and is shifted to ward, informed consent will be taken. Post consent, all study related necessary questionnaires will be administered by the study team, and the sensitive questions would not be asked to the study participants.The questions will be administered on 3rd day of hospitalization to the study participants in the following sequence: Diet, METS(Metabolic equivalent, PSQI (Pittsburgh Sleep Quality Index), SF-36 ( Short Form Health Survey),  PSS (Perceived Stress Scale),  Anger onset scale , PANAS ( Positive and Negative Affect Schedule). To assess risk factors- Perceived stress scale, Pittsburgh Sleep Quality Index, SF-36 questionnaire, diet questionnaire. To assess trigger factors- Anger onset scale, PANAS, METS. To assess risk predictors- lab tests done as per SOC are recorded.

The following data parameters will be recorded: Patient ID, Age, Gender , Occupation Diagnosis, Any substance abuse (Yes/No), specify:, Smoking (Y/N):, Alcohol consumption (Yes/No), specify frequency:, Medical history:, Covid-19 history, Covid vaccine history, Diabetes (Yes/no), Family h/o diabetes. Obesity (BMI), waist circumference., dyslipidemia (Yes/no), Family h/o dyslipidaemia, Hypertension (Yes/no), Family h/o hypertension, Family h/o IHD, History of OSA, Standard of care lab investigations.

The endpoint of study is to elucidate these lacunae in the risk profile of the younger ACS patients.