Pre-hospital delay, clinical characteristics, angiographic findings, and in-hospital mortality in young and middle-aged adults with acute coronary syndrome: a single-centre registry analysis

Abstract

There are several differences between younger and older adults with acute coronary syndrome (ACS). However, few studies have evaluated these differences. We analysed the pre-hospital time interval [symptom onset to first medical contact (FMC)], clinical characteristics, angiographic findings, and in-hospital mortality in patients aged ≤50 (group A) and 51–65 (group B) years hospitalised for ACS. We retrospectively collected data from 2010 consecutive patients hospitalised with ACS between 1 October 2018 and 31 October 2021 from a single-centre ACS registry. Groups A and B included 182 and 498 patients, respectively. ST-segment elevation myocardial infarction (STEMI) was more common in group A than group B (62.6 and 45.6%, respectively; P < 0.001). The median time from symptom onset to FMC in STEMI patients did not significantly differ between groups A and B [74 (40–198) and 96 (40–249) min, respectively; P = 0.369]. There was no difference in the rate of sub-acute STEMI (symptom onset to FMC > 24 h) between groups A and B (10.4% and 9.0%, respectively; P = 0.579). Among patients with non-ST elevation acute coronary syndrome (NSTE-ACS), 41.8 and 50.2% of those in groups A and B, respectively, presented to the hospital within 24 h of symptom onset (P = 0.219). The prevalence of previous myocardial infarction was 19.2% in group A and 19.5% in group B (P = 1.00). Hypertension, diabetes, and peripheral arterial disease were more common in group B than group A. Active smoking was more common in group A than group B (67 and 54.2%, respectively; P = 0.021). Single-vessel disease was present in 52.2 and 37.1% of participants in groups A and B, respectively (P = 0.002). Proximal left anterior descending artery was more commonly the culprit lesion in group A compared with group B, irrespective of the ACS type (STEMI, 37.7 and 24.2%, respectively; P = 0.009; NSTE-ACS, 29.4 and 21%, respectively; P = 0.140). The hospital mortality rate for STEMI patients was 1.8 and 4.4% in groups A and B, respectively (P = 0.210), while for NSTE-ACS patients it was 2.9 and 2.6% in groups A and B, respectively (P = 0.873). No significant differences in pre-hospital delay were found between young (≤50 years) and middle-aged (51–65 years) patients with ACS. Although clinical characteristics and angiographic findings differ between young and middle-aged patients with ACS, the in-hospital mortality rate did not differ between the groups and was low for both of them.

Investigating the efficacy of pre-hospital and in-hospital collaborative treatment platform connected with 120-ambulance in the treatment of patients with acute myocardial infarction

“…It connects the ED, patients, the 120-command center, and ambulance services. It transmits vital signs, live ambulance video feeds, cardiac monitor readings, and ambulance location directly to the hospital [20,21]. A facility is notified prior to a patient being admitted for hospitalization so that necessary reception and treatment arrangements can be made.…”

Efficacy and prognostic impact of Pericarpium Trichosanthis injection combined with nicorandil for intractable angina pectoris in elderly patients: A retrospective study

“…The high prevalence of CAD is closely related to factors such as inflammation, metabolic disorders, arteriosclerosis, and thrombosis. Refractory angina pectoris is a manifestation of CAD, and refers to angina symptoms caused by coronary artery lesions that do not significantly improve or become controllable under conventional treatments (such as medication and percutaneous coronary intervention)[ 2 ]. The elderly population is a high-risk group for refractory angina, and the treatment outcomes are generally poor[ 2 ].…”

“…Refractory angina pectoris is a manifestation of CAD, and refers to angina symptoms caused by coronary artery lesions that do not significantly improve or become controllable under conventional treatments (such as medication and percutaneous coronary intervention)[ 2 ]. The elderly population is a high-risk group for refractory angina, and the treatment outcomes are generally poor[ 2 ]. For refractory angina pectoris, excellent drug treatment options are crucial.…”