Frequency of Triple Vessel Disease in Young Patients <40 Years Presenting with Acute Coronary Syndrome at Tertiary Care Hospitals in Quetta

Background: Coronary artery disease (CAD) is traditionally considered a condition of older adults; however, its occurrence in younger populations is increasing. Acute coronary syndrome (ACS) in patients under 40 years of age represents a distinct subgroup with unique risk profiles. The prevalence of multivessel involvement, particularly triple vessel disease (TVD), in these patients is not well established in Quetta, Pakistan. Objective: To determine the frequency of triple vessel disease among patients younger than 40 years presenting with ACS at tertiary care hospitals in Quetta. Methods: A cross-sectional observational study was conducted across tertiary care hospitals in Quetta. All patients aged <40 years admitted with ACS were included. Diagnosis of ACS was based on clinical evaluation, ECG changes, and cardiac biomarkers. Coronary angiography was performed to assess the extent of vessel involvement. Data were analyzed using [statistical software], with frequency and percentages calculated for categorical variables and mean ± SD for continuous variables. Results: A total of 120 patients were included, with a mean age of 34.8 ± 4.2 years; 92 (76.7%) were male and 28 (23.3%) were female. Among them, the prevalence of TVD was 26 (21.7%). Double vessel disease was observed in 34 (28.3%), single vessel disease in 52 (43.3%), and normal/minimal disease in 8 (6.7%). Major risk factors identified included smoking (58.3%), hypertension (31.7%), diabetes mellitus (26.7%), and family history of CAD (20.0%). Conclusion: Triple vessel disease is not uncommon among young ACS patients in Quetta. The presence of severe multivessel involvement at a young age highlights the urgent need for early detection, aggressive risk factor modification, and tailored interventional strategies.