Acute myocardial infarction in patients aged under 45 years
Nuno Fonseca1, Leonel Bernardino, Isabel Silvestre
1Serviço de Cardiologia do Hospital de São Bernardo, Setúbal, Portugal. nuno.fonseca@netvisao.pt
Insights
Younger patients (under 45) admitted for myocardial infarction showed higher smoking rates, while older patients had more hypertension, diabetes, and coronary artery disease (CAD). Both groups had similar hyperlipidemia rates, emphasizing primary prevention importance.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Coronary artery disease (CAD) is a significant cause of morbidity and mortality, particularly after age 45.
- Myocardial infarction (MI) in younger individuals presents unique epidemiological and clinical characteristics.
Purpose of the Study:
- To investigate the epidemiology and clinical features of patients under 45 years old admitted with myocardial infarction.
- To compare risk factors, clinical presentation, treatment, and complications between younger (under 45) and older (45 and over) MI patients.
Main Methods:
- A retrospective study of 595 patients admitted with myocardial infarction between January 2000 and December 2002.
- Patients were categorized into two groups: Group A (under 45) and Group B (45 and over).
- Analysis included CAD risk factors, clinical profile, therapeutics, and complications.
Main Results:
- Group A comprised 9.4% of patients; Group B comprised 90.6%.
- Smoking prevalence was significantly higher in Group A (57% vs. 23.6%).
- Hypertension, diabetes, and history of CAD were more common in Group B. Fibrinolysis was more frequent in Group A (70% vs. 45.9%). Group B experienced more complications (24% vs. 11%).
Conclusions:
- Younger MI patients exhibit a higher prevalence of smoking, whereas older patients present with more hypertension, diabetes, and established CAD.
- The consistent high rate of hyperlipidemia in both age groups underscores the critical need for primary prevention strategies.
- Younger patients received fibrinolysis more frequently, while older patients had a higher incidence of complications.
Introduction:
Coronary artery disease (CAD) becomes an important cause of morbidity and mortality after the age of 45 years.
Objective:
To evaluate the epidemiology and clinical features of all patients under 45 years old admitted with myocardial infarction.
Methods:
We studied 595 patients admitted with myocardial infarction between January 2000 and December 2002. We analyzed risk factors for CAD, clinical profile, therapeutics and complications (arrhythmic, mechanical and ischemic). The patients were divided into two groups: A--under 45 years old and B-- aged 45 or over.
Results:
Group A--56 patients (9.4%); group B--539 patients (90.6 %). There was a higher prevalence of smoking in group A (57% vs. 23.6%; p < 0.01). Hypertension, diabetes and history of CAD were significantly more common in group B. There were no differences in hyperlipidemia (group A: 43% vs. group B: 43.5%). Fibrinolysis was performed in 28 patients (70%) from group A compared to 40 patients (45.9%; p < 0.01) from group B. Use of digitalis and inotropic agents was greater in group B. No differences were found in other pharmacological therapeutics. We found more complications in group B (24% vs. 11%).
Conclusions:
There was a higher prevalence of smoking in patients under 45 years old and of hypertension, diabetes and CAD in patients aged over 45. The high rate of hyperlipidemia in both groups highlights the importance of primary prevention. Fibrinolysis was performed more frequently in younger patients. There were more complications in older patients.
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