Shah S Sadiq, Noor Lubna, Shah Syed Habib, Din Shahab Ud, Awan Zahid Aslam, Hafizullaht Muhammad
Department of Cardiology, Bacha Khan Medical College, Mardan, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Apr-Jun;22(2):187-90.
Coronary artery disease is now frequently encountered in young adult population. However, being a relatively uncommon entity, not many studies are available in this regard. Therefore, the present study was designed to evaluate the clinical characteristics and angiographic features of patients less than 40 years of age with a history of myocardial infarction and compare them to patients older than 40 years.
A total of 281 patients who underwent coronary angiography from April, 2009 to December, 2009, were included in this study. The patients were divided into two groups on the basis of age. Group A included patients 40 years of age or younger. Group B included patients older than 40 years. Both the groups were compared with respect to gender, hypertension, diabetes mellitus and extent and severity of coronary artery disease as assessed on coronary angiography.
Of the total 281 patients, 45 (16%) were < or =40 years old (Group-A) and 236 (84%) were older than 40 years (Group-B). There was no significant difference between the two groups with respect to the risk factors like gender, hypertension and diabetes mellitus. On coronary angiography, the two groups neither differed in the number of totally occluded vessels, nor in the severity of the culprit lesion. There were only 3 patients in group-A (6.7%) and 5 patients in group-B (2.1%) with normal coronaries (p=NS). Majority (60%) of the patients in group-A had no significant disease or single vessel disease while majority (69%) of the patients in group-B had two or more vessels involved (p<0.001 ). As far as the number of lesions in the coronary arteries is concerned, 62.3% patients had 2 or lesser lesions in group-A while 68.6% patients in group-B had three or more lesions (p=0.001).
These data suggest that in our study, young patients with MI do not have significantly high prevalence of normal coronaries compared to older patients. Young patients are similar to the older patients with respect to severity of CAD. Lesser number of coronaries is involved and there is lesser number of lesions per patient in young patients compared to older ones.
冠心病如今在年轻成年人群中屡见不鲜。然而，作为一种相对不常见的病症，这方面的研究并不多。因此，本研究旨在评估年龄小于40岁且有心肌梗死病史患者的临床特征和血管造影特征，并将其与年龄大于40岁的患者进行比较。
本研究纳入了2009年4月至2009年12月期间接受冠状动脉造影的281例患者。根据年龄将患者分为两组。A组包括40岁及以下的患者。B组包括年龄大于40岁的患者。对两组患者的性别、高血压、糖尿病以及冠状动脉造影评估的冠状动脉疾病范围和严重程度进行比较。
在总共281例患者中，45例（16%）年龄小于或等于40岁（A组），236例（84%）年龄大于40岁（B组）。两组在性别、高血压和糖尿病等危险因素方面无显著差异。在冠状动脉造影中，两组在完全闭塞血管数量和罪犯病变严重程度方面均无差异。A组仅有3例患者（6.7%）冠状动脉正常，B组有5例患者（2.1%）冠状动脉正常（p=无显著差异）。A组大多数患者（60%）无明显疾病或单支血管病变，而B组大多数患者（69%）有两支或更多支血管受累（p<0.001）。就冠状动脉病变数量而言，A组62.3%的患者有2处或更少病变，而B组68.6%的患者有三处或更多病变（p=0.001）。
这些数据表明，在我们的研究中，与老年患者相比，年轻的心肌梗死患者冠状动脉正常的患病率并没有显著升高。年轻患者在冠心病严重程度方面与老年患者相似。与老年患者相比，年轻患者累及的冠状动脉数量较少，且每位患者的病变数量较少。
