Acute coronary syndrome (ACS) is a major cause of morbidity and mortality. Young patients are more likely to have a history of smoking and dyslipidemia, but less likely to have other co-morbidities such as diabetes mellitus, hypertension. Aim: To analyse the frequency of different risk factors for coronary artery disease with focus on novel risk factors in young (≤ 40 years) population presenting with ACS in North East, India. Material and Methods: Patients aged 40 years or less than 40 years

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... age who were diagnosed as case of acute coronary syndrome on the basis of clinical history, examination, ECG changes and biochemical markers. Results: All the patients with ACS have at least one identifiable risk factor and 38 patients (76%) has multiple risk factors.Smoking was the most common risk factor (64%) followed by dyslipidemia (54%), obesity (36%), hypertension (30%),diabetes(28%), positive family history of IHD (18%). Conclusion: Preventive strategies focused on risk factor reduction, by lifestyle modification especially smoking cessation, weight reduction and dietary control should be implemented to protect young adults.