Analysis of risk factors of ST-segment elevation myocardial infarction in young patients

Abstract

BackgroundAcute myocardial infarction (AMI) is often present in old populations and rare in young people. Its incidence significantly increased recent years. The mechanism and disease course of AMI in young people are probably different from that in old population. The aim of this study was to analyze clinical risk factors of STEMI in young patients.MethodsData was collected from consecutive patients ≤ 44 years of age (young; n = 86) and 60–74 years of age (old; n = 65) diagnosed with STEMI, and 79 young age-matched patients without coronary artery disease (CAD), hospitalized between January 2009 and June 2013.ResultsThe young STEMI group had a significantly higher proportion of males (88.37 vs. 53.16%; P < 0.01), smokers (82.56 vs. 49.37%; P < 0.01) and patients with a family history of early CAD (54.65 vs. 32.91%; P < 0.05) than age-matched controls. Young STEMI patients also had significantly higher levels of fasting blood sugar (6.39 vs. 5.25 mmol/L; P < 0.001), glycated hemoglobin (HbA1c) (6.26 vs. 5.45%; P < 0.05), total cholesterol (5.14 vs. 4.65 mmol/L, P < 0.05), and fibrinogen (Fib) (3.39 vs. 2.87; P < 0.01). Compared with the old STEMI group, young STEMI patients had significantly higher proportions of males (88.37 vs. 63.08%; P < 0.01) smokers (82.56 vs. 41.54%; P < 0.01), and those with a family history of early CAD (54.65 vs. 18.46%; P < 0.01). Young STEMI patients also lower Fib (3.39 vs. 3.88 g/L; P < 0.01), less frequent occurrence of angina pectoris before STEMI (13.95 vs. 29.23%; P < 0.05) compared with the old STEMI group. Logistic regression analysis indicated that male sex (OR = 5.891), smoking (OR = 3.500), family history of early CAD (OR = 3.194), Fib (OR = 2.414) and HbA1c (OR = 1.515) are associated with STEMI in young patients.ConclusionIn addition to previously recognized risk factors (male sex, smoking and family history of early CAD), Fib and HbA1c are associated with STEMI in individuals ≤ 44 years of age without antecedent angina pectoris.

Risk factors, prognosis, and secondary prevention of myocardial infarction in young adults in Poland

“…Yunyun et al [24] obtained similar results regarding the much higher prevalence of smoking among young patients with MI than among older patients. As many as 82.56% of individuals with MI aged ≤ 44 years and 41.54% of patients aged 60-74 years confirmed that they were smokers.…”

“…Pineda et al [23] reported hypertension in 28.5% of patients aged ≤ 45 years and in 49.5% of patients aged > 45 years with MI. A similar dependency, but with a higher prevalence of hypertension in both age groups, was observed by Yunyun et al [24]. Hypertension was present in 47.7% of young patients with MI and in 53.9% of older patients.…”

“…Pineda et al [23] reported diabetes in 11.5% of young patients with MI and in 24.5% of patients above the age of 45 years. Yunyun et al [24] reported an even larger proportion of young patients (20.93%), while the prevalence of diabetes among patients with MI above the age of 60 years was 32.3%. Diabetes was reported by Trzeciak et al [4] to be present in 5.5% of patients with MI younger than 40 years and in 24.7% of those above that age.…”

“…The prevalence of smoking among young individuals with MI ranges from 64.5% to 93.7%, depending on the study population [21][22][23][24][25].…”

Effects of coagulation factors and inflammatory cytokines on development of acute myocardial infarction in patients younger than 60 years

“…Recently, it had been reported that the AMI) is a frequent cause of death or severe permanent disability, and the age of AMI patients is becoming increasingly young [12,13]. Thus, the present study was designed to investigate the possible pathogenic mechanism of AMI in patients younger than 60 years related to coagulation factors and inflammatory cytokines.…”