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How likely is coronary artery disease to occur in young patients?
An autopsy series in US communities evaluated young patients (avg age 36 years old) who died of "non-natural" causes revealed coronary atherosclerosis in > 80% of the autopsy sample, with 8% having significant obstructive disease.
The bottom line is simple....be wary of discounting the risk of ACS purely based on a patient's age. The HPI is the most important factor in predicting ACS.
References
Nemetz PN, et al. Recent trends in the prevalance of coronary disease: a population-based autopsy study of nonnatural deaths. Arch Intern Med 2008;168:264-270.
Arbab-Zadeh A, et al. Acute coronary events. Circulation 2012;125:1147-1156.