Background : The frequency of acute myocardial infarction(AMI) in patients under age of 40 years is increasing in recent days. The aim of this study was to identify clinical angiographic features in young adults with AMI and compared with that in older patients.
Methods : The study included total 234 patients admitted to hospital due to AMI. Patients were divided into 2 groups, younger than 40 years (Group 1, n=34) and older than 60 years (Group 2, n=200). We reviewed risk factors, clinical diagonosis and angiographic features in both groups.
Results : Male sex were more frequently found in young patients compared with elderly patients (91.2% vs 58.5%, p<0.001). History of smoking (91.2% vs 31.0%, p<0.001) was more frequent in group 1, but hypertension and diabetes were not major risk factors compared to group 2 (23.5 % vs 59.0%, p<0.001, 38.5% vs 2.9%, p<0.001, respectively). Body mass index (BMI) (26.5±4.2 vs 23.9± 2.9, p=0.002) and triglyceride (118.3±66.9 vs 169.5±115.0 mg/dL) were higher in young patients. Unlike to elderly patients, single vessel disease was prominent in younger patients (78.1% vs 25.5%, p<0.001) and the incidence of STEMI was higher in young patients without statistical significance (79.4 % vs 62.5%, p=0.056). The most frequent infarct related vessel is left anterior descending coronary artery especially in group1 (61.7% vs 54.5%, p<0.006). Two cases in group 1 were vasospasm induced MI and one case was left main disease resulted in death despite angiographicallly successful intervention.
Conclusion : Smoking, obesity, hypertriglyceridemia were more frequent in young patients with MI compared with older patients. Single vessel disease and STEMI were predominant in younger age group suggesting that more abrupt plaque rupture or thrombus formation and less exposure to ischemic conditioning would affect in these patient
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