Symptomatic coronary artery disease in patients aged 21 to 30 years.

One hundred one young people (88 men, 13 women) aged 30 years or younger with arteriographically proved obstructive coronary artery disease (CAD) were identified and reviewed for risk factor prevalence. The men were compared with an age and date-of-catheterization matched control group who were arteriographically normal. Significant risk factors were cigarette smoking (p = 0.001), familial CAD (p = 0.002) and familial CAD manifested by age 50 years or younger (p = 0.005). Serum cholesterol values were significantly higher in the CAD group (p = 0.0001), but in most (54%) were still less than 250 mg/dl. Arteriography showed a spectrum of CAD: 1-vessel in 57, 2-vessel in 21 and 3-vessel in 22. One patient had significant left main CAD. Follow-up was obtained for all of the 94 American subjects. One-year mortality was 3% and 5-year mortality was 20%. The causes of death were predominantly cardiac: myocardial infarction in 10 patients, congestive heart failure in 2 and sudden death in 6; 3 patients died of noncardiac causes.