Angiograhic profile and in-hospital outcome of young patients presenting with ST Elevation Myocardial Infarction (STEMI) in tertiary cardiac hospital

Abstract

Objective: To assess the angiographic profile and in hospital outcomes of primary percutaneous coronary intervention among young patients presenting with acute ST Elevation Myocardial Infarction and underwent primary PCI.
 Methods: The retrospective observational study was conducted at Shahid Gangalal National Heart Centre (SGNHC), Kathmandu, from july 2020 to June 2021, and included acute ST-Elevation Myocardial Infarction patients underwent primary percutaneous coronary intervention (PCI). Data was collected on demographic, angiographic, and in-hospital outcomes. Patients <45 years were considered young. Data was analysed using SPSS 21.
 Results: Total 104 patients met the inclusion criteria. Mean age of presentation was 40.16 ± 4.42 years. Over three-fourth of the patients were male 80 (76.9%). Smoking was the most prevalent risk factor with 61 (58.6%) patients followed by hypertension 35 (33.6%) and dyslipidemia 23 (22.1%). Single Vessel Disease (SVD) was the most common finding seen in 62 patients (59.6%) and Left Anterior Descending Artery (LAD) was the most commonly involved artery seen in approximately three fourth patients 80 (76.9%) followed by RCA 61 (58.6%) and LCX 15(14.4%). Left Main Coronary Artery is involved in 3 patients (2.9%). 6 (5.8%) patients suffered from cardiogenic shock either at admission or during hospital stay. Total In hospital mortality was seen in 3 (2.9%) patients.
 Conclusions: Among young patients (<45 years old) with STEMI who underwent PPCI in underdeveloped country majority are males and smoking is the most prevalent risk factor. Single vessel disease and LAD involvement is the most common angiographic finding and they have favorable in-hospital outcome.

Risk factors, lab parameters, angiographic characteristics and outcomes of coronary artery disease in young South Asian patients: a systematic review

“…The proportion of patients with RCA involvement ranged from 10.3% 25 to 58.6%. 22 Except for six studies, RCA involvement was more frequent than LCX involvement. Similarly, LCX was involved in 1.3% 63 to 51.0% 60 of the South Asian population.…”

“…21 Both the lowest and highest percentages of smokers in the South Asian study population were reported in India. Nepalese patients who were smokers were observed in 58.6% 22 to 80.8% 14 of the study population. Similarly, smoking was prevalent in 14.3% 23 to 64.7% 24 of Pakistani patients and in up to 77.4% 25 of Bangladeshi patients.…”

“… 61 Pandey et al. 22 reported Nepal’s highest prevalence of TVD (only 12.5%). The details of each study of SVD, DVD, and TVD are described in Table 1 of Supplementary File S1.…”

“…Positive family histories were observed in as many as 60% of the patients. 30 Only five studies in Nepal reported the prevalence of young patients with CAD who had a positive family history; prevalences ranged from 2.9% 22 to 31.6%. 38 The prevalences of a positive family history of CAD or young CAD in Pakistani and Bangladeshi populations were 57.1% 32 and 60.0% 30 , respectively.…”

Myocardial infarction in young patients. Is everything so obvious?

“…Самыми распространенным ФР у молодых являлись курение и дислипидемия, в то время как артериальная гипертензия (АГ) и СД встречались достоверно реже [4,5,10]. Также, по данным многих исследований, ожирение и отягощенная наследственность по сердечно-сосудистым заболеваниям достоверно чаще регистрируется у молодых пациентов с ИМ, однако в некоторых работах значимых различий выявлено не было [11,12]. Имеются данные, что в 20% случаев клиника ИБС в молодом возрасте обусловлена неатеросклеротическими факторами, такими как коронарные аномалии, дисплазии соединительной ткани и аутоиммунные заболевания [13].…”