LEFT MAIN CORONARY-ARTERY STENOSIS IN YOUNG-PATIENTS

Among 1,041 patients less than 45 years old who underwent coronary arteriography from 1972 to 1977, left main coronary stenosis ≥ 50 percent was present in 31 men (3.4 percent) and in 10 women (7.2 percent, P<0.05). The degree of stenosis did not correlate with the duration of symptoms, the severity of angina, the presence of a previous myocardial infarction, nor with the number of risk factors. The clinical and angiographic features in young men did not seem to differ from those described in unselected populations; however, in young women, left main coronary stenosis was often an isolated lesion associated with a short duration of symptoms, a high prevalence of hypertension, no previous myocardial infarction, and a normal ventriculogram, suggesting the possibility that a different pathophysiologic mechanism might be involved. Two deaths occurred at angiography (4.9 percent). Thirty patients underwent coronary artery bypass surgery, with one operative death and one late death; good functional results were obtained, and 21 out of 28 survivors (75 percent) were asymptomatic after a mean follow-up of 29 months.