Analysis of risk factors of ST-segment elevation myocardial infarction in young patients
Wang Yunyun, Li Tong1, Liu Yingwu
1Cardiac Center, Third Central Hospital of Tian Jin, Tian Jin 300170, China. litong3zx@sina.com.
Insights
Young STEMI patients exhibit distinct risk factors including male sex, smoking, and family history. Elevated fasting blood sugar, HbA1c, total cholesterol, and fibrinogen are also associated with STEMI in this demographic.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Acute Myocardial Infarction (AMI) incidence is rising in younger populations.
- Understanding STEMI (ST-elevation myocardial infarction) in young individuals is crucial due to potentially different disease mechanisms.
- This study investigates clinical risk factors specific to STEMI in young patients.
Purpose of the Study:
- To identify and analyze the clinical risk factors associated with STEMI in patients aged 44 years or younger.
- To compare these risk factors with those in older STEMI patients and age-matched controls without coronary artery disease.
Main Methods:
- Retrospective analysis of STEMI patients (≤ 44 years) and age-matched controls.
- Comparison of clinical data between young STEMI patients (n=86) and older STEMI patients (n=65).
- Logistic regression analysis to determine significant risk factors.
Main Results:
- Young STEMI patients showed higher rates of male sex, smoking, and family history of early CAD compared to controls.
- Elevated fasting blood sugar, HbA1c, total cholesterol, and fibrinogen were observed in young STEMI patients.
- Compared to older STEMI patients, young patients had higher proportions of males, smokers, and family history of early CAD, but lower fibrinogen and less frequent prior angina.
Conclusions:
- Male sex, smoking, and family history of early CAD are key risk factors for STEMI in young individuals.
- Fibrinogen (Fib) and Glycated Hemoglobin (HbA1c) are significantly associated with STEMI in young patients, particularly those without prior angina.
- These findings highlight specific risk profiles for STEMI in younger populations, aiding targeted prevention and management strategies.
Background:
Acute myocardial infarction (AMI) is often present in old populations and rare in young people. Its incidence significantly increased recent years. The mechanism and disease course of AMI in young people are probably different from that in old population. The aim of this study was to analyze clinical risk factors of STEMI in young patients.
Methods:
Data was collected from consecutive patients ≤ 44 years of age (young; n = 86) and 60-74 years of age (old; n = 65) diagnosed with STEMI, and 79 young age-matched patients without coronary artery disease (CAD), hospitalized between January 2009 and June 2013.
Results:
The young STEMI group had a significantly higher proportion of males (88.37 vs. 53.16%; P < 0.01), smokers (82.56 vs. 49.37%; P < 0.01) and patients with a family history of early CAD (54.65 vs. 32.91%; P < 0.05) than age-matched controls. Young STEMI patients also had significantly higher levels of fasting blood sugar (6.39 vs. 5.25 mmol/L; P < 0.001), glycated hemoglobin (HbA1c) (6.26 vs. 5.45%; P < 0.05), total cholesterol (5.14 vs. 4.65 mmol/L, P < 0.05), and fibrinogen (Fib) (3.39 vs. 2.87; P < 0.01). Compared with the old STEMI group, young STEMI patients had significantly higher proportions of males (88.37 vs. 63.08%; P < 0.01) smokers (82.56 vs. 41.54%; P < 0.01), and those with a family history of early CAD (54.65 vs. 18.46%; P < 0.01). Young STEMI patients also lower Fib (3.39 vs. 3.88 g/L; P < 0.01), less frequent occurrence of angina pectoris before STEMI (13.95 vs. 29.23%; P < 0.05) compared with the old STEMI group. Logistic regression analysis indicated that male sex (OR = 5.891), smoking (OR = 3.500), family history of early CAD (OR = 3.194), Fib (OR = 2.414) and HbA1c (OR = 1.515) are associated with STEMI in young patients.
Conclusion:
In addition to previously recognized risk factors (male sex, smoking and family history of early CAD), Fib and HbA1c are associated with STEMI in individuals ≤ 44 years of age without antecedent angina pectoris.
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