患有急性心肌梗塞的年轻和老年患者:风险因素和血管学特征的差异
Marios Sagris1, Panagiotis Theofilis1, Vasiliki Mistakidou2
11st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.
概括
患有心肌梗塞 (MI) 的年轻患者通常是吸烟者,冠状动脉疾病不那么严重,但治疗不足. 了解它们独特的风险因素和病理生理学是改善预防和治疗的关键.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 公共卫生 公共卫生
背景情况:
- 冠状动脉疾病 (CAD) 主要影响老年人.
- 55岁以下的成年人心肌梗塞 (MI) 的发生率正在上升.
- 年轻和老年MI患者表现出不同的病理生理特征,斑块形态和危险因素概况.
研究的目的:
- 为了比较年轻 (<55岁) 与老年 (>55岁) 患者的临床,血管学和病理生理学特征,这些患者因心脏病入院治疗.
- 为了确定这些年龄组之间的风险因素,动脉硬和疾病严重程度的差异.
- 为了突出治疗年轻心脏病患者的潜在差异.
主要方法:
- 一组977名心脏病发作患者 (322名年轻人,655名老年人) 在5年内住院治疗.
- 收集了基线特征,日常习惯和病史.
- 评估血管学特征,血管病变,动脉硬 (脉冲波速度[PWV],增强指数[AIx]) 和炎症生物标志物.
主要成果:
- 年轻的MI患者更频繁地吸烟 (49.3%与23.8%相比),与老年患者相比,高血压,糖尿病,血脂不良和心房的发病率更低.
- 年轻人表现出明显较低的动脉硬性 (PWV,AIx),并且更有可能患有非阻塞性或单血管性疾病 (55.6%vs45.8%).
- 尽管病情不那么严重,但大多数年轻的心脏病患者的治疗不足.
结论:
- 年轻的心脏病发作患者的特点是吸烟,动脉硬度指标受损,冠状动脉阻塞性疾病较少.
- 这些患者经常接受低于最佳的治疗,这表明需要量身定制的治疗策略.
- 对年轻成年人风险因素和疾病过程的更好理解对于改善心脏病发作预防和管理至关重要.
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