Langzeitschicksal nach Myokardinfarkt bei Männern unter 40 Jahren

Kovacsics, H.; Kovacsics, A.; Petersen, Johannes; Stürzenhofecker, P.; Roskamm, H.

doi:10.1007/978-3-642-72336-0_81

Cited by 4 publications

(3 citation statements)

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“…3,6,7,29 In contrast, the risk of nonfatal reinfarction has been reported to be similar to that of older patients.7 Survival may be lower among young women than men, whereas no sex difference seems to exist in the recurrence rate of nonfatal reinfarctions.30 An extremely poor prognosis has been reported for the small group of women with multiple-vessel disease. 31 A prospective cohort study of 109 unselected cases referred to our unit with a first myocardial infarction before the age of 45 has shown that young men with decreased fibrinolytic activity, dyslipoproteinaemia involving VLDL and HDL, extensive coronary atherosclerosis and poor left ventricular function are at high risk of reinfarction within three years of the primary events.32 Plasma PAI-1 activity elevation, although firmly associated with hypertriglyceridaemia and several other risk indicators, was independently related to recurrences.…”

Section: Prognosismentioning

confidence: 81%

“…Taken together, the most extensive studies of young men with myocardial infarction have unequivocally singled out a common risk factor profile comprising heavy smoking, hypercholesterolaemia, a family history of premature CHD and hypertension. [2][3][4][5][6] In Sweden, the high proportion of immigrants has also been a striking features and comparison between countries has indicated that the risk factor pattern in young men might differ as a consequence of varying cultural and genetic influences. 2 The total risk factor burden appears to be heavier in younger than in older patients,6 and some established risk factors such as smoking, hypercholesterolaemia and a family history of premature CHD also seem to be more common in the young patient,6,9 compared to others such as hypertension and diabetes mellitus which are more prevalent in older age groups.…”

Section: Clinical Aspectsmentioning

confidence: 98%

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Myocardial infarction at a young age: mechanisms and management

Hamsten

1991

Vascular Medicine Review

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IntroductionMyocardial infarction at a young age is, by definition, an uncommon condition which normally afflicts men. 1 The observation of a striking heterogeneity in coronary morphology among young postinfarction patients has led to speculation concerning basic differences in aetiological factors and pathogenic mechanisms. It has been suggested that two major disease patterns prevail: one characterized by severe coronary atherosclerosis and one which is predominantly thrombotic. Occlusive thrombosis with subsequent recanalization of the infarct-related coronary artery is thus a likely event in the significant proportion of young postinfarction patients without definite signs of atherosclerosis in the coronary angiogram.This review summarizes the view of a cardiologist and clinical scientist with a keen interest in the mechanisms underlying premature coronary atherosclerosis and coronary thrombosis. It is based on personal clinical experience and research over a 10-year period in an academic cardiology unit to which all survivors of myocardial infarction under the age of 45 admitted to coronary care units in the greater Stockholm area were referred. The review aims to delineate the major mechanisms and clinical features of myocardial infarction at a young age and to discuss some aspects of clinical management which are particularly important to young patients. Clinical aspectsGeneral risk factor pattern Given the low incidence of myocardial infarction before the age of 45, the case-control method has been the only study design by which to generate hypotheses regarding possible aetiologies and mechanisms. However, there are few major studies of representative groups of patients which have also included adequate control groups; instead, case reports and uncontrolled studies illustrating diverse aspects of early-onset coronary heart disease (CHD) are abundant. Taken together, the most extensive studies of young men with myocardial infarction have unequivocally singled out a common risk factor profile comprising heavy smoking, hypercholesterolaemia, a family history of premature CHD and hypertension.2-6 In Sweden, the high proportion of immigrants has also been a striking features and comparison between countries has indicated that the risk factor pattern in young men might differ as 46 a consequence of varying cultural and genetic influences.2 The total risk factor burden appears to be heavier in younger than in older patients,6 and some established risk factors such as smoking, hypercholesterolaemia and a family history of premature CHD also seem to be more common in the young patient,6,9 compared to others such as hypertension and diabetes mellitus which are more prevalent in older age groups.Studies in our unit, which also included lipoprotein fractionations and aspects of haemostatic function, have identified a set of major risk factor profile components including heavy smoking, dyslipoproteinaemias involving both very low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and high-density lipoprotein (H...

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Section: Prognosismentioning

confidence: 81%

Section: Clinical Aspectsmentioning

confidence: 98%

Myocardial infarction at a young age: mechanisms and management

Hamsten

1991

Vascular Medicine Review

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“…Bei älteren Menschen mit schlecht tonisiertem Herzen ist jedoch eine Herzvolumenverringerung moglich. Die einschlagigen Mitteilungen in der Literatur sind nicht einheitlich (3,5,8,14,15 Unsere Ergebnisse stimmen mit Mitteilungen die Uber keine oder nur unbedeutende Verringerung des Herzvolumens nach Gesundheitssport berichten (3,5,14,15). Das durchschnittliche Herzvolumen der männlichen Patienten (n = 95) von 737,3 ml und das der weiblichen Patienten (n = 30) von 600,2 ml entspricht den Durchschnittsangaben untrainierter Personen (6,10,11).…”

Section: Discussionunclassified