Clinical Features of Myocardial Infarction in Young Japanese Patients

Abstract

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...

Gender differences in risk factors and clinical outcomes in young patients with acute myocardial infarction

“…Previous studies have demonstrated that the young AMI group has a higher proportion of males, presenting with modifiable risk factors such as smoking, hyperlipidaemia, and being more overweight with respect to the older age group 15 16. Similar to Western data, we found that young men have more AMI than women of the same age group 17 18.…”

Association of elevated triglycerides and acute myocardial infarction in young Hispanics

“…In some prior studies, the association between triglycerides and CAD became statistically insignificant after adjusting for HDL cholesterol and other cardiovascular risk factors (24,25). older patients tend to have multi-vessel disease (2)(3)(4)(5)(6). The same studies also demonstrated that young patients have shorter length of hospital stay and lower morbidity and mortality when…”

“…Traditional comorbid conditions, however, including hypertension, diabetes mellitus and previously established coronary artery disease (CAD), are less prevalent in this patient population (1, 2,[4][5]. Previous studies have also demonstrated a higher likelihood of single vessel CAD (2)(3)(4)(5)(6) and lower rates of in-hospital morbidity and mortality when young patients with AMI are compared with older patients (1-6).…”

A qualitative study of younger men's experience of heart attack (myocardial infarction)

“…Myocardial infarction risk profiles also differ for younger adults. Smoking and hyperlipidaemia are higher, while hypertension and diabetes rates are lower, and the majority of MI patients under 45 are male (Al‐Murayeh, Al‐Masswary, Dardir, Moselhy, & Youssef, ; Anderson et al ., ; Jinnouchi et al ., ; Khan, Khan, Khan, Shah, & ul Hassan, ; Morillas et al ., ; Zimmerman, Cameron, Fisher, & Grace, ). Although this gender imbalance is not fully understood, it has been suggested that oestrogen protects younger women from atherosclerosis (Maxwell, ), while lifestyle factors such as smoking and drinking predispose men to MI (Solomon, ).…”