Coronary artery disease in young women: Risk factors and their association with angiographic profile and disease severity from a tertiary care center in India

Abstract

Coronary artery disease (CAD) in young women is being increasingly identified, often with atypical presentations and a higher prevalence of nonobstructive disease. This study aimed to evaluate the clinical profile, angiographic characteristics, and factors associated with obstructive CAD and multivessel disease. A retrospective observational study of 82 young women undergoing coronary angiography. Clinical features, risk factors, left ventricular function, and angiographic findings were analyzed. Most patients were aged 41–45 years (53.7%). Dyslipidemia (52.4%) and hypertension (50%) were the most common risk factors. Chest pain (85.4%) predominated, with over half presenting as acute coronary syndromes (ACSs). Obstructive CAD was present in 50%, most commonly as single-vessel disease (30.5%) with predominant involvement of the left anterior descending. Nonobstructive CAD (26.8%) and normal coronaries (23.2%) were also common. Hypertension ( P = 0.001) and dyslipidemia ( P < 0.0001) were significantly associated with obstructive CAD, while diabetes ( P = 0.002) was significantly associated with multivessel disease. CAD in young women often presents as ACS and is significantly associated with dyslipidemia and hypertension, while diabetes is significantly associated with multivessel disease, reflecting greater disease severity. A substantial proportion had nonobstructive disease suggestive of the myocardial infarction with nonobstructive coronary arteries/angina with nonobstructive coronary arteries spectrum, emphasizing the role of microvascular mechanisms and the need for early diagnosis and risk factor control.