Acute coronary syndromes in young patients: Presentation, treatment and outcome

Schoenenberger, Andreas W.; Radovanovic, Dragana; Stauffer, Jean‐Christophe; Windecker, Stephan; Urban, Philippe; Niedermaier, G; Keller, Pierre-Frédéric; Gutzwiller, Félix; Erné, Paul

doi:10.1016/j.ijcard.2009.11.009

Cited by 154 publications

(157 citation statements)

References 33 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…1,3,4,7,8,16,17) Our study results were in accordance with these previous studies. Although being overweight has not been considered to be a definite risk factor for MI, it has been suggested to be a risk factor for MI in young populations.…”

Section: Discussionsupporting

confidence: 93%

Clinical Features of Myocardial Infarction in Young Japanese Patients

et al. 2013

View full text Add to dashboard Cite

SummaryClinical features and outcomes of acute myocardial infarction (AMI) in the young have been poorly investigated. The aim of this study was to investigate the clinical features and hospital outcomes of AMI in young Japanese. We conducted a case-control study. A total of 53 consecutive AMI patients whose age was ≤ 45 years old were assigned to the young group and 106 AMI patients whose age was > 45 years old were assigned to the non-young group. We compared the clinical features and hospital outcomes between the two groups. Compared with the non-young group, the young group was associated with male sex, hyperlipidemia, current smoking, being overweight, single vessel disease, and Killip class I on admission. There were no differences in the length of hospital stay or major adverse cardiac events between the groups. However, mortality and ventricular rupture were slightly lower in the young. In conclusion, young AMI patients had clinical characteristics different to those of the non-young patients. Compared to non-young patients, modifiable risk factors such as smoking, hyperlipidemia, and being overweight were associated with young AMI patients. (Int Heart J 2013; 54: 123-128) Key words: Angioplasty, Age, Ischemic heart disease A lthough the incidence of coronary artery disease in the young is still lower than that in the non-young, 1,2) coronary artery disease in the young has been increased recently. The clinical features and outcomes of acute myocardial infarction (AMI) in the young are considered to be different from those in the non-young. [1][2][3][4][5][6][7][8][9] As diet patterns and lifestyles in the young are different from the non-young, 10,11) specific and unique considerations are needed for young AMI patients. It is important to elucidate the clinical features and outcomes of AMI in young patients. We conducted a case-control study to elucidate the clinical features of AMI in young patients. MethodsCases and controls: We identified acute myocardial infarction patients from the hospital records of our medical center from January 2007 to March 2012. A diagnosis of AMI consisted of elevation of creatine kinase (at least 2-fold above the normal upper limit), and the presence of 1 of the following 2 criteria; (1) persistent chest pain or (2) ST-segment elevation or depression in the 12-lead electrocardiogram compatible with AMI. During the study period, 53 consecutive AMI patients whose age was ≤ 45 years old were assigned to the young group (Case group). 8,12) The control patients were selected from our AMI patients whose age was > 45 years old during the same study period. We designed the study so the ratio of cases to controls would be 1 to 2. To minimize the selection bias, consecutive AMI patients whose age was > 45 years old were assigned to the non-young group (Control group). In addition, to minimize any bias related to the therapeutic strategy for AMI, consecutive selection was conducted for each year. This study was approved by the institutional review board. PCI procedures: PCI was p...

show abstract

Section: Discussionsupporting

confidence: 93%

Clinical Features of Myocardial Infarction in Young Japanese Patients

et al. 2013

View full text Add to dashboard Cite

show abstract

“…A similar proportion (6.3%) was noted by Schoenenberger et al [12] in the Swiss AMIS Plus study, while a much higher proportion (> 50%) was reported by Xie et al [15] in a population of young Asian women with MI. Zimmerman et al [10] noted diabetes in only 3% of men with an AMI aged ≤ 35 years (n = 294) but in 9% of women with AMI aged ≤ 45 years (n = 210).…”

Section: Discussionsupporting

confidence: 79%

“…In a large analysis by Cole et al [14], single vessel disease was identified in 58% of CAD patients below 40 years of age. Similar observations of predominantly single vessel disease in young adults compared to more common 2-or 3-vessel disease in older populations were made in multiple studies in Europe, United States and also Asia [15]. In most previous clinical trials, the distribution of coronary atherosclerotic lesions was similar and not related to the age group, with proximal LAD most frequently involved, followed by the RCA and the left circumflex artery.…”

Section: Discussionsupporting

confidence: 76%

“…The prevalence of dyslipidaemia in young adults with CAD has been estimated by most authors at about 40-50% [12,15]. In a cross-sectional American study by Khawaja et al [22], a strong increasing trend for the prevalence of hyperlipidaemia, from 39% in 1980-1989 to 73% in 2000-2007, was found among patients below 50 years of age with CAD undergoing PCI.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Maroszyńska-Dmoch

Wożakowska−Kapłon

2016

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: Coronary artery disease (CAD) in young adults under 40 years of age is a growing medical, social, psychological and economical problem, related to the prevalence of civilization-related diseases and unhealthy lifestyle. The problem of CAD in young people has not been characterised as well as in older individuals, as the available data mostly come from case reports and small series, often related to genetic aspects and familial occurrence of the disease. Aim:To assess clinical and angiographic characteristics of young adults with CAD and to evaluate in-hospital and long-term mortality in this patient group. The study combined a retrospective and a prospective approach.Methods: A total of 239 patients aged 40 years or younger who underwent coronary angiography (CAG) in the Swietokrzyskie Centre of Cardiology in Kielce in [2001][2002][2003][2004][2005][2006][2007][2008] were included in this study. Demographic characteristics, risk factor profile, laboratory test results, electrocardiographic and echocardiographic findings, CAG findings, and in-hospital mortality were assessed retrospectively in the selected groups. During the second stage of the study, clinical and mortality data were obtained prospectively in 130 patients (54.4% of the study group) during up to 5 years of follow-up. Results:The mean patient age was 35.1 ± 4.4 years. Men made up 86.2% of the study sample, and the proportion of rural area residents was 54.8%. Among young patients with acute coronary syndromes (ACS), the most common presentation (52.8%) was ST segment elevation myocardial infarction (STEMI). Angiographically normal coronary arteries were found in 37.2% of CAD patients and in 16.9% of patients with the diagnosis of ACS. The mean degree of coronary artery lumen stenosis was 75.4% in the group with significant atherosclerotic coronary lesions (50-90%) and 95.9% in the group demonstrating a critical coronary obstruction (≥ 90%). Single-vessel disease was identified in 61.9% of patients with a positive result of CAG (stenosis > 50%, CORO(+) group). The most common location of significant atherosclerotic coronary lesions was the left anterior descending artery (61.6%) followed by the right coronary artery (27.4%). The most prevalent conventional cardiovascular risk factors were lipid abnormalities, cigarette smoking and an increased body mass index ≥ 25 kg/m 2 , followed by a family history of CAD and hypertension. The proportion of patients with abnormal lipid profile, cigarette smoking and overweight or obesity was particularly high in the CORO(+) group (85.6%, 83.9%, and 64.4%, respectively). In-hospital mortality rate was low, at 0.7% among ACS patients. Long-term mortality during up to 5 years of follow-up was not so favourable, at 7.75% in ACS patients and 8.5% in the CORO(+) group. Conclusions:The population of young patients with CAD is predominantly male, rural, and characterised by a low socioeconomic status. The aetiology of CAD in this patient group differs significantly from that in older patients a...

show abstract

“…16,17 Similar finding has been observed by another group where majority (70%) of the young patients with ACS presented with STEMI. 18 Mean FBG was relatively high in the case group than that in the control group (p = 0.054). Serum LDL-C and serum triglycerides levels were significantly higher in the former group than in the latter group (p = 0.026 and p = 0.015, respectively).The study demonstrates that younger patients have lesser number of coronary artery involvement and less severe disease (in terms of percentage of occlusion and number of vessels involved) compared to elderly(p = <0.001).…”

Section: Discussionmentioning

confidence: 86%

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Ahmad¹,

Mm²,

Khan³

et al. 2017

Bangladesh Heart J

View full text Add to dashboard Cite

Abstract:Aims: To compare the risk factors and pattern of coronary artery involvement in young acute coronary syndrome patients with that of the elderly. Results: Study population was divided into two subgroups, those 18-40 years were considered as young and those >40 years were considered as elderly. Young patients had greater prevalence of smoking, dyslipidemia and positive family history of Ischemic Heart Disease (IHD), whereas hypertension was more prevalent in the elderly. Younger patients mainly presented with STEMI and predominantly had single vessel disease (SVD), whereas elderly patients frequently presented with NSTEMI and Unstable angina and had higher incidence of double vessel disease (DVD) and triple vessel disease (TVD). MethodsConclusion: Younger patients had a different pattern of risk factors and coronary artery involvement in comparision to the elderly.

show abstract

Acute coronary syndromes in young patients: Presentation, treatment and outcome

Cited by 154 publications

References 33 publications

Clinical Features of Myocardial Infarction in Young Japanese Patients

Clinical Features of Myocardial Infarction in Young Japanese Patients

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

Contact Info

Product

Resources

About