الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Younger patients with coronary heart disease < 45 years in male and <55 in women is defined as premature coronary artery disease which has different etiological factors, clinical presentation and angiographic finding from mature patients The present study comprised 200 patients who underwent diagnostic coronary angiography in our catheterization laboratory in Cardiovascular Department at Mansoura Specialized Internal Medicine Hospital between August 2013 and August 2014 as case control comparative study. The protocol was approved by our ethical committee and written consent was taken from the study subject. This study is conducted to evaluate clinical condition, risk factors and angiographic characteristics among patients with premature CAD and comparing them with older patients The patients were classified into two groups: Group1: comprised 100 patients (mean age 40.3 + 7.15) with premature CAD which is defined as CAD occurs in male < 45 years old and in female <55 years old. Group2: comprised 100 Patients (mean age 59.6 + 7.1) with mature CAD which is defined as CAD occurs in male > 45 years old and in female >55 years old. We excluded valvular heart disease, dilated and hypertrophic cardiomyopathy, previous coronary intervention, chronic renal or liver disease, coronary artery bypass graft and neoplastic diseases Comparative analysis between two groups with full history regarding age, gender, risk factors (DM, HTN, smoking types, dyslipidemia, drug addiction, family history of CAD, sedentary life, menstrual history and number of risk factors) History of the first clinical presentation of patients in the two groups were classified into either STEMI, NSTEMI, UAP, angina equivalent or non-specific complaints ECG analysis for heart rate and ST segment deviations, ECHO Doppler study for EF, left ventricular dimensions, RSWMA and presence of ischemic mitral regurge, and coronary angiography analysis for dominant artery, culprit lesion, number of culprit arteries, significance of lesions, type of lesions, presence of coronary ectasia and calcification were done and compared between the two groups In our study we found that males were more affected with premature CAD while no gender difference in mature CAD group Clinical presentation was different in the two groups with STEMI and non- specific symptoms presentation was significantly increased in premature CAD group while patients in the mature group was presented more by NSTEMI Regarding risk factors smoking was significantly increased in premature CAD group while prevalence of hypertension , diabetes mellitus, family history of CAD and the presence of multiple risk factors (≥ 3 risk factors) were increased significantly in mature CAD while no difference in dyslipidemia and sedentary life between both groups.