{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:47:49Z","timestamp":1781736469999,"version":"3.54.5"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: The average age of presentation of coronary artery disease (CAD) is one decade younger in the Saudi population relative to other patients worldwide. It is imperative to investigate the prevalence of premature coronary artery disease (PCAD) risk factors in Saudi Arabia\u2019s younger population in order to prevent the incidence of cardiovascular diseases in the future. Thus, the present study aimed to evaluate the severity and identify the risk factors associated with PCAD in patients under the age of 50 at King Saud University Medical City (KSUMC), Saudi Arabia. Methods: This observational retrospective study was conducted between June 2022 and June 2023 at King Saud University Medical City, Riyadh, Saudi Arabia. A total of 718 participants were included in the study. The patients, confirmed by electrocardiographic and\/or angiographic findings of coronary artery disease, were divided into three age groups: group 1 (&lt;40 years), group 2 (40\u201345 years), and group 3 (45\u201350 years). The severity of vessel occlusions was evaluated using the Gensini scoring system. Electrocardiographic findings, sociodemographic variables, and risk factors were also taken into consideration. Results: The mean age of patients in group 1 was 35.2 \u00b1 4.5 years, in group 2 was 43.0 \u00b1 1.3 years, and in group 3 was 48.4 \u00b1 1.4 years. Patients in group 2 had a significantly higher BMI (31.3 \u00b1 10.5) compared to patients in group 3 (29.4 \u00b1 5.3; p = 0.015). Nearly 55% of patients under 40 years had 2 or 3 vessel occlusions according to the vessel score. The percentage of patients with inferior ST elevation was significantly higher in group 1 (&lt;40 years, 11.2%) compared to groups 2 (40\u201345 years, 10.1%) and 3 (45\u201350 years, 6.0%; p = 0.001). Non-specific ST-T changes were more common in group 1 (31.4%) and group 2 (32.0%) compared to group 3 (28.4%). Although not statistically significant, left main artery occlusion tended to be higher in group 3 (8.6%) compared to groups 1 (4.6%) and 2 (4.5%; p = 0.229). Hyperlipidemia levels were significantly higher in patients with a Gensini score &gt; 39 compared to those with a Gensini score &lt; 39 (47.9% vs. 37.5%, respectively; p = 0.05). The prevalence of smoking was about 54% in group 1, followed by type 2 diabetes mellitus, dyslipidemia, and hypertension (37%, 36%, and 33%, respectively). Conclusions: This study suggested that PCAD Saudi patients below 40 years of age had a higher percentage of inferior ST elevation compared to older patients, while non-specific ST-T changes were significantly higher in older patients. Astonishingly, more than 50% of patients in all groups had two or three vessel occlusions. There was a high prevalence of modifiable risk factors, such as smoking, in younger patients, whereas hyperlipidemia was a risk factor for PCAD in all age groups. In addition, hyperlipidemia was highly correlated with severe vessel occlusion according to the Gensini score. Therefore, early preventive measures should be taken into consideration to reduce the future burden of cardiovascular complications in this population.<\/jats:p>","DOI":"10.3390\/jcm14051618","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T08:04:44Z","timestamp":1740643484000},"page":"1618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Severity and Risk Factors Associated with Premature Coronary Artery Disease in Patients Under the Age of 50 in Saudi Population: A Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-4037","authenticated-orcid":false,"given":"Thamir","family":"Al-khlaiwi","sequence":"first","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-8406","authenticated-orcid":false,"given":"Syed Shahid","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9366-7776","authenticated-orcid":false,"given":"Hessah","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Cardiology Science, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Albackr","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 19910, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razan","family":"Alobaid","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lama","family":"Alrumaih","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faye","family":"Sendi","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad","family":"Almuqbil","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update From the GBD 2019 Study","volume":"76","author":"Roth","year":"2020","journal-title":"J. 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