Bajaj Sharad, Shamoon Fayez, Gupta Nishant, Parikh Rupen, Parikh Neil, Debari Vincent A, Hamdan Aiman, Bikkina Mahesh
Department of Internal Medicine, St Joseph's Regional Medical Center, Paterson, New Jersey 07503, USA.
Coron Artery Dis. 2011 Jun;22(4):238-44. doi: 10.1097/MCA.0b013e3283452e7f.
Less than 10% of patients presenting with acute myocardial infarction (AMI) are young adults. The primary objective of this study was to provide an overview of similarities and dissimilarities among younger and older patients presenting with AMI with the expectation of using the information as an aid in primary and secondary preventions in the future.
From the database of 3527 patients with AMI admitted from January 2001 to December 2008, young adults aged 21-40 years (n = 43) who were diagnosed with ST-segment elevation myocardial infarction were identified. They were then compared with their older counterparts who were admitted from January 2007 to December 2008 subdivided into age groups of 41-60 (n = 86) and 61-80 years (n = 51). Data on clinical cardiovascular risk factors, demographic features, and angiographic findings were gathered and analyzed.
Only 2.58% of ST-segment elevation myocardial infarction patients who were admitted to our hospital over an 8-year period were less than 40 years. Young adults were found to be predominantly male patients (P = 0.04) and had positive family history for coronary artery disease (P = 0.0005). Diabetes and hypertension were less prevalent in the younger group (P = 0.048 and 0.078). Analysis of lipid profile showed comparatively higher total cholesterol, low-density lipoprotein and high-density lipoprotein values in the younger group (≤ P = 0.004). Angiographically, youngsters had propensity toward single-vessel involvement (P = 0.0001).
The risk factor profile and the angiographic involvement differ considerably in the high-risk younger adults and substantiate the need for an aggressive approach directed toward primary and secondary preventions of premature cardiovascular disease.
急性心肌梗死（AMI）患者中，年龄小于40岁的年轻成年人不到10%。本研究的主要目的是概述年轻和老年AMI患者之间的异同，以期将来将这些信息用于一级和二级预防。
从2001年1月至2008年12月收治的3527例AMI患者数据库中，识别出年龄在21 - 40岁之间、诊断为ST段抬高型心肌梗死的年轻成年人（n = 43）。然后将他们与2007年1月至2008年12月收治的老年患者进行比较，老年患者分为41 - 60岁组（n = 86）和61 - 80岁组（n = 51）。收集并分析临床心血管危险因素、人口统计学特征和血管造影结果的数据。
在我院8年期间收治的ST段抬高型心肌梗死患者中，年龄小于40岁的仅占2.58%。发现年轻成年人主要为男性患者（P = 0.04），且有冠心病家族史阳性（P = 0.0005）。糖尿病和高血压在年轻组中患病率较低（P = 0.048和0.078）。血脂分析显示，年轻组的总胆固醇、低密度脂蛋白和高密度脂蛋白值相对较高（≤P = 0.004）。血管造影显示，年轻人倾向于单支血管受累（P = 0.0001）。
高危年轻成年人的危险因素谱和血管造影受累情况有很大差异，这证实了对过早发生的心血管疾病进行积极的一级和二级预防的必要性。
