Clinical and Coronary Angiographic Insights Into Acute ST-Elevation Myocardial Infarction in Young Patients: A Study
Nitin Ramanathan1, Hisham Mohammed Babu1, Aparnna Nair2
1Internal Medicine, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research, Mysore, IND.
Insights
Early-onset coronary artery disease (CAD) predominantly affects young adult males, with smoking being the primary risk factor. This study examined STEMI in patients under 45, finding chest discomfort and LAD artery blockages most common.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Early-onset coronary artery disease (CAD) presents significant community health challenges.
- It is linked to increased risks of recurrent ischemic events and mortality.
- Understanding STEMI in younger populations (≤45 years) is crucial for targeted interventions.
Purpose of the Study:
- To investigate the contributing factors, clinical presentation, and management of first-time ST-elevation myocardial infarction (STEMI) in individuals aged 45 or younger.
- To identify key risk variables and angiographic findings in this demographic.
- To evaluate treatment strategies and outcomes for early-onset STEMI.
Main Methods:
- An observational study conducted over six months in a cardiology unit.
- Inclusion of 100 consecutive patients diagnosed with STEMI.
- Data collection on patient demographics, risk factors, symptoms, angiographic results, and interventions.
Main Results:
- The study included 100 patients with a mean age of 42.5 years; 89% were male.
- Smoking was the most prevalent risk factor, followed by obesity, diabetes, and hypertension.
- Chest discomfort was the most common symptom (99%), with the Left Anterior Descending (LAD) artery being most frequently affected (24%).
- Percutaneous coronary intervention (PCI) was performed in 50% of patients; Coronary Artery Bypass Grafting (CABG) was required in 8%.
- No mortality was recorded during the study period.
Conclusions:
- Acute myocardial infarction (STEMI) is most common in very young adult males.
- Smoking is the leading risk factor for early-onset STEMI.
- Anterior wall myocardial infarction, often caused by LAD artery occlusion, is the most frequent clinical manifestation.
Abstract:
Background This investigation addresses the major effects of early-onset coronary artery disease (CAD) on community health, noting its association with elevated incidences of recurrent ischemic events and mortality. The study specifically explores the contributing factors, clinical symptoms, angiographic findings, and management strategies for individuals aged 45 or younger who experience their initial ST-elevation myocardial infarction (STEMI). Methodology This observational study took place over a six-month period within the cardiology unit, involving 100 sequential patients diagnosed with STEMI. Results With a mean age of 42.5 years, the research had 100 patients, of which nine (9%) were under 25, 24 (24%) were between 26 and 35, and 67 (67%) were over 36. Of these, 89 (89%) were male. The following risk variables were found: obstructive CAD, smoking, being overweight, diabetes, hypertension, chest discomfort, and syncope. In 99 patients (99%), the most prevalent symptom was chest discomfort. Most often impacted was the left anterior descending (LAD) artery in 24 patients (24%), then the right coronary artery in 14 patients (14%). A total of 50 patients (50%) had percutaneous coronary intervention (PCI), with 15 patients (15%) undergoing elective PCI, 10 patients (10%) with pharmaco-invasive PCI, and 20 patients (20%) receiving primary PCI. In eight cases (8%), coronary artery bypass grafting (CABG) was required. Furthermore, 40 patients (40%) were under medical care, and 32 patients (32%) had recanalized and normal coronaries. No mortality was recorded in this study. Conclusions Acute myocardial infarction is most frequently seen in very young adult males, and the most common risk factor is smoking. The most common clinical manifestation, anterior wall myocardial infarction, was caused by the main source of involvement, the LAD artery.
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