Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Abstract

Epidemiological evidence suggests that the incidence of acute myocardial infarction (AMI) among people under 40 years of age has an increasing trend in recent years. Smoking, hypertension, diabetes mellitus, family history, and gender (male) are considered as classic risk factors for CHD, but the pathogenesis of CHD in young people is not exactly the same. Moreover, the relationship between the pattern of coronary artery disease and risk factors in young patients with acute myocardial infarction is inconclusive. In this study, we retrospectively studied the clinical data of 150 AMI patients treated in our hospital from January 2020 to May 2021. The patients were divided into the young group and elderly group according to the difference in age. The number of coronary artery lesions, the degree of coronary artery stenosis, the distribution dominance typing, the position of the lesions, and the presence of collateral circulation were observed and compared between the two groups. Multivariate logistic regression analysis was used to investigate the risk factors affecting coronary artery lesions in young patients with AMI. The results showed that the number of coronary lesions in young patients with AMI was mainly single-vessel, and the dominant type of distribution was mainly right dominant type. The stenosis degree is lighter than that of elderly patients, and the incidence of collateral circulation is lower than that of elderly patients, but the position of the lesions has no obvious regular. Smoking, staying up late, HDL-C, and LDL-C/ApoB were independent factors affecting the number of coronary artery lesions, and the changes of HDL-C and LDL-C/ApoB had an important influence on the degree of coronary stenosis in young patients. This provides a new idea for clinical treatment.

A Systematic Review on the Risk Modulators of Myocardial Infarction in the “Young”—Implications of Lipoprotein (a)

“…Smoking is still one of the greatest and most frequent risk factors among young MI patients [ 18 ]. According to Singh et al, in STEMI patients, smoking (37.6%) was shown to be the most prevalent risk factor for young STEMI subjects (patients under 45 years), followed by diabetes mellitus (16.8%), and hypertension (16%) [ 19 ].…”

Prognostic factors in young patients with ST-segment elevation myocardial infarction

“…Previous study reported that young AMI patients have a heavier thrombotic burden compared to older patients [23]. Although young patients have low atherosclerosis and small plaques [24], plaque rupture and thrombus formation may more likely happen during external emergency events and mood changes [25,26] with rare collateral circulation protection clinically [11]. Therefore, the abovementioned imaging diagnoses are important for clinical reperfusion therapy in young patients with acute AMI.…”

“…It has been reported that most young patients have a lower rate of coronary atherosclerosis and a higher proportion of nonobstructive stenosis and single-vessel lesions compared with older patients. Smoking, hyperlipidemia, and cardiovascular family history may be important influencing factors [11]. Meanwhile, the risk factors for many diseases may change as the change in lifestyle and dietary habits.…”

Analysis of clinical characteristics and risk factors of young acute myocardial infarction

“…In a study exploring risk factors in young AMI patients, poor lifestyle such as smoking and staying up late were found to be independent risk factors for acute myocardial infarction. 19 In a study on the relationship between smoking cessation and survival in young AMI patients, it was found that young patients with a history of smoking were more likely to develop ST-segment elevation myocardial infarction and that mortality in AMI patients was reduced by 70% after 1 year of smoking cessation. 20 The Gensini score can be used to assess coronary atherosclerosis and is suitable for the screening of AMI patients.…”