Hidden Knowledge Gaps in Premature Coronary Artery Disease Awareness Among Young Adults in Palestine

Background Premature coronary artery disease (PCAD) is increasingly recognized as a significant public health issue. Globally, cardiovascular diseases (CVDs) account for approximately 32% of all deaths, with a rising incidence among younger adults. In Palestine, data on PCAD awareness are limited. This study assessed the knowledge, attitudes, and practices regarding PCAD and its risk factors among Palestinians in the West Bank. Methods A cross-sectional online survey was conducted from April to June 2025 in ten cities in the West Bank. Using a validated Arabic questionnaire adapted from regional studies, 737 participants aged 18–45 years were recruited through social media. Data were analyzed using R (v4.4.3) employing descriptive statistics and Pearson’s chi-square tests (significance: p ≤ 0.05). Results Most participants (75%) recognized that CAD could affect individuals < 45 years of age, but only 40% viewed PCAD as a major local problem. The key risk factors were correctly identified as obesity (86%), smoking (82%), and hyperlipidemia (80%). Critical gaps were identified: 51% were unaware of opioids as a risk factor, and 31% were uncertain about diabetes. Higher knowledge was correlated with age 20–29 years (p < 0.001), university education (p = 0.012), and affected relatives (p < 0.001). Females demonstrated superior knowledge of smoking (p = 0.014) and stress (p = 0.028), healthier dietary practices (p < 0.001), and lower smoking rates (14% vs. 52%, p < 0.001). Conclusion Although foundational PCAD knowledge exists, critical gaps persist, particularly regarding diabetes, opioids, and local disease burden. Gender and education significantly influenced the knowledge, attitudes, and practice. Public health strategies should prioritize early risk factor education, especially regarding metabolic syndrome and medication effects, and promote healthy lifestyles to curb PCAD incidence.