Myocardial infarction in young adults: Risk factors and clinical features

Kanitz, Mark G.; Giovannucci, Sam J.; Jones, J. Stephen; Mott, Michael L.

doi:10.1016/0736-4679(95)02089-6

Cited by 99 publications

(114 citation statements)

References 22 publications

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“…[8][9][10][11] For example, the majority of AMIs before age 40 occur in young men, as 81-94% of young AMI patients are male. [7][8][9][10][11][12] An increased number of risk factors are seen in younger AMI patients, with most young AMI patients (89-99%) having at least one cardiac risk factor. 7,9,10,12 Cigarette smoking is by far the most common risk factor in young AMI patients (62-94%), followed by family history of premature CAD (15-84%) and hyperlipidemia (20-61%).…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12] An increased number of risk factors are seen in younger AMI patients, with most young AMI patients (89-99%) having at least one cardiac risk factor. 7,9,10,12 Cigarette smoking is by far the most common risk factor in young AMI patients (62-94%), followed by family history of premature CAD (15-84%) and hyperlipidemia (20-61%). [7][8][9][10][11][12] In contrast to the older AMI patients, less than 12% of young AMI patients have diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12] In contrast to the older AMI patients, less than 12% of young AMI patients have diabetes mellitus. [7][8][9][10][11][12] Young patients with AMI also differ from older patients in their extent of CAD. More than half of young AMI patients have been found to have only single-vessel CAD by angiography.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,10,12 Cigarette smoking is by far the most common risk factor in young AMI patients (62-94%), followed by family history of premature CAD (15-84%) and hyperlipidemia (20-61%). [7][8][9][10][11][12] In contrast to the older AMI patients, less than 12% of young AMI patients have diabetes mellitus. [7][8][9][10][11][12] Young patients with AMI also differ from older patients in their extent of CAD.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Young AMI patients have different risk factor profiles, less CAD by angiography, and better outcomes than older patients with AMI. [6][7][8][9][10][11][12][13][14] The lower incidence of CAD in patients under 40 and the differences in the characteristics of CAD in this age group make young patients with chest pain a distinct subgroup of patients. The purpose of this study was to describe the incidence of ACS in young chest pain patients, their clinical presentation, hospital course, and outcome at 30 days.…”

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confidence: 99%

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Characteristics and Outcomes of Young Adults Who Present to the Emergency Department with Chest Pain

Walker

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Shofer

et al. 2001

Academic Emergency Medicine

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Abstract.Background: Most studies of emergency department (ED) chest pain patients exclude patients <30-40 years old. As a result, the clinical course of these patients is poorly described. Objective: To study the clinical characteristics, hospital course, and 30-day outcomes of ED chest pain patients <40 years old. The hypothesis was that patients <40 years old without a cardiac history and with normal electrocardiograms (ECGs) or no cardiac risk factors would be at a <1% risk for acute coronary syndromes (ACSs) and 30-day adverse cardiovascular (CV) events. Methods: This was a prospective cohort study of noncocaine-using ED patients, 24-39 years old, who received an ECG for chest pain between July 9, 1999, and October 23, 2000. Structured data collection at presentation included demographics, chest pain description, history, laboratory, and ECG data. Hospital course was followed daily. Thirty-day follow-up was performed by telephone. The main outcomes were discharge diagnosis and 30-day adverse CV events [acute myocardial infarction (AMI), death, percutaneous intervention (PCI), or coronary artery bypass grafting (CABG)]. Results: A total of 487 patients presented 527 times and comprised the study group. Patients were most often 30-39 years old (71%), female (60%), and African-American (73%). Thirty-two percent were admitted. Five hundred seven of 527 patient visits (96%) had 30-day follow-up. Patients had the following cardiac risk factors: tobacco, 37%; hypertension, 22%; family history, 19%; diabetes mellitus, 6%; cholesterol, 6%; prior angina, 3%; known coronary artery disease, 3%; and prior AMI, 2%. Patients usually had unremarkable ECGs (61% normal, 98% nonischemic). Overall, 11 of 527 patients had adverse CV events (2.1%; 95% CI = 0.9% to 3.3%): 8 AMIs (1.5%), 4 deaths (0.8%), 5 PCIs (0.9%), and no CABG. Twenty-five patients had a final diagnosis of ACS (4.7%; 95% CI = 2.9% to 6.5%). The incidence of ACS in the 210 patients without a cardiac history and without cardiac risk factors was 0.5% (95% CI = 0% to 1.4%). At 30 days, none of these 210 patients had AMI, PCI, CABG, or death (0%, 95% CI = 0% to 1.4%). The incidence of ACS in the 312 patients with normal ECGs and a negative cardiac history was 0.3% (95% CI = 0% to 0.9%). At 30 days, there was no AMI, PCI, or CABG in these 312 patients, and one patient with metastatic cancer died (adverse CV event 0.3%, 95% CI = 0% to 0.9%). Conclusions: Although young patients, as a whole, have a 4.7% risk of ACSs and a 2.1% risk of adverse CV events at 30 days, those without known cardiac disease or any cardiac risk factors had a <1% risk of ACSs and were free from adverse CV events over 30 days. Likewise, young patients without a cardiac history and with a normal ECG had a <1% risk of ACSs and adverse CV events at 30 days. It may be reasonable to expedite outpatient management and limit unnecessary admissions in these cohorts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Characteristics and Outcomes of Young Adults Who Present to the Emergency Department with Chest Pain

Walker

Sites

Shofer

et al. 2001

Academic Emergency Medicine

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Acute ST‐elevation Myocardial Infarction in Young Patients: 15 Years of Experience in a Single Center

Chua¹,

Hung

Shyu

et al. 2010

Clinical Cardiology

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Background: There have been few studies done regarding young patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate the clinical characteristics and coronary angiographic features in young patients with STEMI. Methods: We collected data on 849 consecutive patients with STEMI from 1992 to 2006. Baseline clinical characteristics, coronary anatomy, and outcome were compared in young (≤45 yrs) and older patients (>45 yrs). Results: Young patients presented 11.6% of all patients with STEMI. These patients were predominantly male (92.9% vs 80.3%, P < 0.001), more likely to smoke (75.8% vs 47.2%, P < 0.001), obese (48.2% vs 27.9%, P = 0.002), have higher triglyceride levels (176.9 ± 153.8 mg/dL vs 140.7 ± 112.7 mg/dL, P = 0.005), and lower high-density lipoprotein cholesterol (37.1 ± 7.9 mg/dL vs 42.8 ± 14.3 mg/dL, P = 0.005) than older patients. Also, younger patients had a shorter hospital stay (7.1 ± 4.9 d vs 8.5 ± 6.7 d, P = 0.04), less in-hospital morbidity (29.3% vs 39.7%, P = 0.02), and mortality (3.0% vs 12.3%, P = 0.002). Killip class III or IV could predict in-hospital morbidity and mortality in young patients. Both groups had similar rates of repeated percutaneous coronary intervention (PCI; 45.5% vs 41.5%, P = 0.23) and reinfarction (6.1% vs 3.2%, P = 0.32). Mortality rate during follow-up was significantly lower in younger patients (3.0% vs 19.6%, P < 0.001). Conclusion: Cigarette smoking, obesity, and dyslipidemia were the most important modifiable risk factors in young patients with STEMI. These patients had a better outcome than older patients without differences in repeated PCI and reinfarction between them. Only Killip class III or IV could predict in-hospital morbidity and mortality in young patients with STEMI.

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Discovering Medical Knowledge using Association Rule Mining in Young Adults with Acute Myocardial Infarction

et al. 2013

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The knowledge discovery has been widely applied to mine significant knowledge from medical data. Nevertheless, previous studies have produced large numbers of imprecise patterns. To reduce the number of imprecise patterns, we need an approach that can discover interesting patterns that connote causality between antecedent and consequence in a pattern. In this paper, we propose association rule mining method that can discover interesting patterns that include medical knowledge in Korean acute myocardial infarction registry that consists of 1,247 young adults collected by 51 participating hospitals since 2005. Proposed method can remove imprecise patterns and discover target patterns that include associations between blood factors and disease history. The association that blood factors affect to disease history is defined as target pattern. In our experiments, the interestingness of a target pattern is evaluated in terms of statistical measures such as lift, leverage, and conviction. We discover medical knowledge that glucose, smoking, triglyceride total cholesterol, and creatinine are associated with diabetes and hypertension in Korean young adults with acute myocardial infarction.

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Myocardial infarction in young adults: Risk factors and clinical features

Cited by 99 publications

References 22 publications

Characteristics and Outcomes of Young Adults Who Present to the Emergency Department with Chest Pain

Characteristics and Outcomes of Young Adults Who Present to the Emergency Department with Chest Pain

Acute ST‐elevation Myocardial Infarction in Young Patients: 15 Years of Experience in a Single Center

Discovering Medical Knowledge using Association Rule Mining in Young Adults with Acute Myocardial Infarction

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