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ASSESSMENT OF RISK FACTORS OF MYOCARDIAL INFARCTION IN YOUNG PERSONS
D Nurkina1, M Baimuratova2, L Zhussupbekova3
11Kazakhstan Medical University, «Kazakhstan School of Public Health», Almaty, Kazakhstan.
Insights
Cardiovascular diseases are a leading global cause of death, with rising rates in young people. This review examines international approaches to understanding risk factors for myocardial infarction in younger populations.
Area of Science:
- Cardiology and Public Health Research
- Focus on noncommunicable diseases and cardiovascular risk assessment
Background:
- Cardiovascular diseases are the primary cause of death globally, accounting for half of all noncommunicable diseases.
- Kazakhstan identified as high cardiovascular risk region due to rising mortality rates.
- Increasing prevalence of myocardial infarction in younger individuals (up to 44 years) necessitates research into early-onset risk factors.
Purpose of the Study:
- To review international approaches for assessing risk factors of myocardial infarction in young populations.
- To investigate the impact of additional risk factors beyond traditional ones, considering different myocardial infarction types.
Main Methods:
- Content analysis of research on myocardial infarction risk factors in young individuals.
- Inclusion of national guidelines and WHO recommendations.
- Literature search of electronic databases (PubMed, eLibrary) from 1999-2022 using specific keywords and MeSH terms.
Main Results:
- International research supports the role of classic risk factors (hypertension, smoking, dyslipidemia, diabetes, inactivity, family history) in early atherosclerosis.
- Distinction between Type 1 (atherogenesis-related) and Type 2 (ischemia imbalance) myocardial infarction highlights different pathogenetic mechanisms.
- Need for research into additional factors like inflammation, genetic polymorphisms, and endothelial dysfunction for Type 2 myocardial infarction.
Conclusions:
- High mortality and disability from early cardiovascular events in young people present a significant socioeconomic problem.
- Further research is needed to identify new markers, develop risk stratification algorithms, and enhance prevention strategies for early-onset myocardial infarction.
- Understanding diverse pathogenetic mechanisms is crucial for effective management and prevention in younger populations.
Abstract:
In terms of morbidity and mortality, cardiovascular illnesses are the main cause of death worldwide. Half of all noncommunicable diseases on the earth are caused by them. Due to the steadily rising mortality rates from circulatory diseases in Kazakhstan, our region was identified as having a high cardiovascular risk in 2021 when the updated Score 2 (Systematic COronary Risk Evaluation) scale was developed. There has been a recent increase in this pathology's prevalence among younger people (up to 44 years). In this regard, a large number of scholars are engaged in active research into the variables that affect the onset of coronary heart disease in this population, particularly its acute forms, which frequently mark the onset of the disease in this age group. The research of international experts supports the impact of classic risk factors such arterial hypertension, smoking, dyslipidemia, diabetes mellitus, inactivity, and loaded anamnesis on the early development of atherosclerosis. The Fourth Universal Definition distinguishes five different forms of myocardial infarction, and if the first type is directly linked to atherogenesis, the second type develops as a result of ischemia imbalance in the absence of coronary artery obstructive lesions. There are currently no definite, widely acknowledged standards for the identification and management of type 2 myocardial infarction. Thereby there was a need to research the impact of additional risk factors, such as subclinical systemic inflammation, genetic polymorphism of genes involved in lipid metabolism, thrombosis, and responsible for the development of endothelial dysfunction, given the differences in the pathogenetic mechanisms of different types of myocardial infarction. It's still up for debate whether comorbidity has any impact on the frequency of early cardiovascular events in the population of young individuals. Aim is to study international approach in an assessment of risk factors of the development of myocardial infarction at young population. The review used content analysis on the research topic, national guidelines, WHO recommendations. The electronic databases Pubmed, eLibrary from 1999 to 2022 were used as sources of information. The search was conducted on the keywords «myocardial infarction», «infarction in young», «risk factors» and MeSH terms «myocardial infarction/etiology», «myocardial infarction/young», «myocardial infarction/risk factors». Of the 50 sources found, 37 corresponded to the research request. This field of scientific study is one of the most important today because of the prevalence of formation and poor prognosis of non-atherothrombogenic myocardial infarctions, compared with type 1 infarcts. Numerous foreign and domestic authors have been motivated to look for new markers of the early onset of coronary heart disease, develop adequate risk stratification algorithms, and create efficient primary and secondary prevention strategies at the level of primary healthcare and hospitals as a result of the high mortality and disability rates in this age group that are a significant economic and social problem.
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