Shiraishi Jun, Kohno Yoshio, Yamaguchi Shinichiro, Arihara Masayasu, Hadase Mitsuyoshi, Hyogo Masayuki, Yagi Takakazu, Shima Takatomo, Sawada Takahisa, Tatsumi Tetsuya, Azuma Akihiro, Matsubara Hiroaki
Department of Cardiology, Kyoto First Red Cross Hospital, Kyoto, Japan.
Circ J. 2006 May;70(5):518-24. doi: 10.1253/circj.70.518.
Data on the medium- and long-term prognosis of young Japanese patients with acute myocardial infarction (AMI) are still lacking.
In the present study, 1,458 AMI patients were enrolled in the AMI-Kyoto Multi-Center Risk Study between January 2000 and December 2003. Of these, clinical characteristics and medium-term prognosis were retrospectively compared in 21 young patients < 40 years (young group), and 190 non-young patients 60-70 years old (non-young group) who could be followed after hospital discharge. The young group was all male and had higher prevalence of current smoking and greater body mass index, but previous myocardial infarction (MI) and hypertension were more prevalent in the non-young group. The young group had a higher prevalence of single-vessel disease and a lesser incidence of left circumflex coronary artery as the culprit lesion. The acquisition rates of Thrombolysis In Myocardial Infarction 3 flow after primary percutaneous coronary intervention did not differ between the 2 groups, but the data of maximal creatine kinase was significantly higher in the young group. During the follow-up period (average 2.42 years for young, 2.37 years for non-young), survival and event-free survival rates and incidence of major adverse cardiac events (MACE) did not differ between the 2 groups. The predictor of MACE during follow-up period was the presence of multivessel disease in the young group, whereas the presence of multivessel disease, history of previous MI and longer hospitalization were the predictors of MACE in the non-young group.
These results suggest that the medium-term prognosis in young AMI patients is comparable to that of non-young AMI patients in Japan.
日本年轻急性心肌梗死（AMI）患者的中长期预后数据仍然缺乏。
在本研究中，2000年1月至2003年12月期间，1458例AMI患者纳入了AMI-京都多中心风险研究。其中，对21例年龄<40岁的年轻患者（年轻组）和190例60 - 70岁的非年轻患者（非年轻组）进行了回顾性比较，这些患者出院后可进行随访。年轻组均为男性，当前吸烟率更高，体重指数更大，但非年轻组既往心肌梗死（MI）和高血压更为普遍。年轻组单支血管病变的患病率较高，以左旋支冠状动脉为罪犯病变的发生率较低。两组在直接经皮冠状动脉介入治疗后心肌梗死溶栓3级血流的获得率无差异，但年轻组的最大肌酸激酶数据显著更高。在随访期间（年轻组平均2.42年，非年轻组平均2.37年），两组的生存率、无事件生存率和主要不良心脏事件（MACE）发生率无差异。年轻组随访期间MACE的预测因素是多支血管病变的存在，而非年轻组MACE的预测因素是多支血管病变的存在、既往MI病史和更长的住院时间。
这些结果表明，日本年轻AMI患者的中期预后与非年轻AMI患者相当。
