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Influence of Clinical, Angiographic, and Developmental Characteristics and COVID-19 Severity and Vaccination Status
Yethindra Vityala1, Mahesh Palagudi2, Sneha Para3
1Honorary International Faculty, AJ Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India.
Insights
Younger patients experiencing acute myocardial infarction (AMI) often have higher cholesterol and triglyceride levels and are more likely to be smokers. Unvaccinated individuals with AMI had more severe COVID-19 outcomes.
Area of Science:
- Cardiology
- Genetics
- Infectious Diseases
Background:
- Atherosclerosis is a primary cause of ischemic cardiovascular disease (CVD).
- Genetic factors contribute to 20%-40% of acute myocardial infarction (AMI) cases in individuals under 50.
- Coronavirus disease 2019 (COVID-19) increases the risk of blood clots and AMI.
Purpose of the Study:
- To characterize clinical, angiographic, and developmental factors in patients aged ≤45 with AMI.
- To assess COVID-19 severity and vaccination status in younger AMI patients.
Main Methods:
- Retrospective analysis of 2624 patients with AMI.
- Review of coronary angiography, percutaneous coronary intervention results, and medical reports.
- Inclusion criteria: age >18 years, universal AMI definition; exclusion criteria: missing data.
Main Results:
- Higher total cholesterol and triglyceride levels were observed in patients aged ≤45 years compared to older patients.
- Unvaccinated patients, across both age groups, experienced more severe and critical COVID-19 infections.
- Younger AMI patients were more frequently smokers and had fewer comorbidities like hypertension or diabetes.
Conclusions:
- Younger AMI patients exhibit distinct risk factor profiles, including hypercholesterolemia, hypertriglyceridemia, and a higher prevalence of smoking.
- These patients were more likely to present with single-vessel disease, Type C lesions, and a history of drug-eluting stent use.
- COVID-19 severity was linked to vaccination status, with unvaccinated individuals facing worse outcomes.
Background:
Atherosclerosis is the most common cause of ischemic cardiovascular disease (CVD). However, approximately 20%-40% of cases of acute myocardial infarction (AMI) in patients aged <50 years can be attributed to genetic factors, and coronavirus disease 2019 (COVID-19) is a risk factor for blood clots and AMI. We aimed to describe the clinical, angiographic, and developmental characteristics and COVID-19 severity and vaccination status in patients aged ≤45 years with AMI.
Methods:
We retrospectively analyzed 2624 patients with AMI by reviewing the results of coronary angiography and percutaneous coronary intervention and medical reports. The study included patients aged >18 years who met the universal definition of AMI but excluded those with missing medical records or coronary angiograms.
Results:
In total, 2624 patients with AMI (aged 18-85 years) were included in the study and divided into two groups based on age: ≤45 (n = 1286) and >45 years (n = 1338). Total cholesterol and triglyceride levels were significantly higher in patients aged ≤45 years (5.6 ± 2.1 and 3.2 ± 2.1 mmol/L, respectively, P < 0.007) than in those aged >45 years (6.3 ± 1.8 and 3.1 ± 2.0 mmol/L, respectively, P < 0.001). Overall, 1745 and 879 patients were unvaccinated and fully vaccinated, respectively; severe and critical COVID-19 infections were more common among unvaccinated patients in both age groups.
Conclusions:
Younger patients with AMI were more likely to be smokers with no hypertension, diabetes mellitus, or previous AMI. In contrast, they were more likely to have hypercholesterolemia and hypertriglyceridemia, single-vessel disease, Type C lesions, and a history of drug-eluting stent use.
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