Vol 79, No 10 (2021)
Original article
Published online: 2021-08-31

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Acute myocardial infarction in young patients

Wojciech Zasada12, Beata Bobrowska2, Krzysztof Plens1, Artur Dziewierz13, Zbigniew Siudak4, Andrzej Surdacki3, Dariusz Dudek23, Stanisław Bartuś23
Pubmed: 34472075
Kardiol Pol 2021;79(10):1093-1098.

Abstract

Background: Acute myocardial infarction (AMI) is an incredibly destructive disease when it occurs in a young patient. Thus, the investigation of the disease presentation and treatment options seem to be particularly important in young patients with AMI.
Aims: The study objective was to investigate the differences between young and older patients diag-nosed with AMI in terms of clinical characteristics and treatment strategies.
Methods: The patient data comes from the National Registry of Procedures of Invasive Cardiology (ORPKI). Between 2014 and 2017, data of more than 230 000 patients with a diagnosis of AMI were collected in that registry. Young patients were defined as under 40 years old.
Results: Young patients with AMI (n = 3208, 1.3%) compared with older patients with AMI were more often men (86.3% vs. 65.8%; P <0.001) with higher body weight (mean 85.9 vs. 79.7 kg; P <0.001). Typical risk factors of coronary heart disease were less frequent in younger patients than in older patients. However, in the under-40 group, there was a significantly higher number of current smokers (37.5% vs. 23.0%; P <0.001). Young patients with AMI were more often diagnosed with ST-segment elevation myocardial infarction (STEMI; 62.0% vs. 50.0%; P <0.001). Moreover, they had more frequently non-significant ste-nosis in coronary arteries diagnosed (14.4% vs. 6.8%; P <0.001). The left anterior descending artery was more frequently an infarct-related artery in young patients (51.3% vs. 36.3%; P <0.001). Bioresorbable vascular scaffolds were more commonly implanted in young patients with AMI than in the older ones (5.6% vs. 0.9%; P <0.001). The relative number of AMI in the young patients increased from 1.20% in 2014 to 1.43% in 2017.
Conclusions: Smoking is the most common risk factor in young adults. The relative number of AMI in young patients is growing.

References

  1. McManus DD, Gore J, Yarzebski J, et al. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011; 124(1): 40–47.
  2. Ochała A, Siudak Z, Legutko J, et al. Percutaneous interventions in cardiology in Poland in the year 2014. Summary report of the Association of Cardiovascular Interventions of the Polish Cardiac Society AISN PTK. Postepy Kardiol Interwencyjnej. 2015; 11(3): 177–181.
  3. Siudak Z, Tokarek T, Dziewierz A, et al. Reduced periprocedural mortality and bleeding rates of radial approach in ST-segment elevation myocardial infarction. Propensity score analysis of data from the ORPKI Polish National Registry. EuroIntervention. 2017; 13(7): 843–850.
  4. Hassan A, Jaffe R, Rubinshtein R, et al. Characterization of coronary artery disease in young adults and assessment of long-term outcomes. Isr Med Assoc J. 2018; 20(10): 613–618.
  5. Gulati A, Mathew C, Calton R. Young hearts go ischemic too. J Assoc Physicians India. 2018; 66(9): 58–61.
  6. Mirza AJ, Taha AY, Khdhir BR. Risk factors for acute coronary syndrome in patients below the age of 40 years. Egypt Heart J. 2018; 70(4): 233–235.
  7. Chhabra ST, Kaur T, Masson S, et al. Early onset ACS: An age based clinico-epidemiologic and angiographic comparison. Atherosclerosis. 2018; 279: 45–51.
  8. Anjum M, Zaman M, Ullah F. Are their young coronaries old enough? Angiographic findings in young patients with acute myocardial infarction. J Ayub Med Coll Abbottabad. 2019; 31(2): 151–155.
  9. Andreenko EYu, Yavelov IS, Loukianov ММ, et al. Kardiologiia. 2018; 58(11): 24–34.
  10. Wahrenberg A, Magnusson PKe, Discacciati A, et al. Family history of coronary artery disease is associated with acute coronary syndrome in 28,188 chest pain patients. Eur Heart J Acute Cardiovasc Care. 2020; 9(7): 741–747.
  11. Lv S, Liu W, Zhou Y, et al. Hyperuricemia and smoking in young adults suspected of coronary artery disease ≤ 35 years of age: a hospital-based observational study. BMC Cardiovasc Disord. 2018; 18(1): 178.
  12. Polańska-Skrzypczyk M, Karcz M, Rużyłło W, et al. Bedside prediction of 9-year mortality after ST‑segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Kardiol Pol. 2019; 77(7-8): 703–709.
  13. Wybraniec MT, Mizia-Stec K, Gąsior Z, et al. Long-term effects of the Managed Care After Acute Myocardial Infarction program: an update on a complete 1-year follow-up. Kardiol Pol. 2020; 78(5): 458–460.