Mahjoob Mohammad Parsa, Sadeghi Soheila, Khanaman Hamide Falahaty, Naderian Mohammadreza, Khaheshi Isa
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rom J Intern Med. 2018 Jun 1;56(2):90-95. doi: 10.1515/rjim-2017-0048.
Coronary artery disease (CAD) is uncommon among young adults and may have certain characteristics that are different from those in older patients. The aim of the current study was to determine the risk factors of CAD, important laboratory data and angiographic findings in young patients with CAD and to compare them with the old patients.
Patients with typical chest pain whose CAD was confirmed by coronary angiography were included in the study. These patients were divided into 2 groups: ≥ 45 and < 45 years old; the risk factors of CAD and angiographic findings were determined in each group and further compared.
Finally, 231 patients with CAD were included in the study. Thirty-five (30.4%) of patients younger than 45 years and 58 (50.0%) aged ≥ 45 had diabetes mellitus (P = 0.002). Statistically remarkable differences were observed between the two groups regarding hypertension (P < 0.001), myocardial infarction (P < 0.001), Gensini score Median (P < 0.001), ejection fraction in echocardiography (P < 0.001) and fasting blood sugar in laboratory data (P = 0.006). The older group, compared with the younger one, had higher left anterior descending (LAD) artery (P < 0.001), right coronary artery (RCA) (P < 0.001), 3 vessel disease (P < 0.001) and 2-vessel disease (P = 0.044); on the other hand, 1-vessel disease was higher in patients aged < 45(P < 0.001).
The risk profile and angiographic findings are different in young patients with CAD compared to older patients. Young patients with CAD tend to be male with a positive familial history, but with less diabetes or hypertension. The older patients had higher 3 vessel disease, 2-vessel disease and left anterior descending (LAD) artery and right coronary artery (RCA) involvements. In contrast, 1-vessel disease was higher in young patients aged <45.
冠状动脉疾病(CAD)在年轻人中并不常见,可能具有一些与老年患者不同的特征。本研究的目的是确定年轻CAD患者的危险因素、重要实验室数据和血管造影结果,并与老年患者进行比较。
将经冠状动脉造影证实患有CAD且有典型胸痛的患者纳入研究。这些患者分为两组:≥45岁和<45岁;确定每组CAD的危险因素和血管造影结果,并进一步比较。
最终,231例CAD患者纳入研究。年龄<45岁的患者中有35例(30.4%)患有糖尿病,年龄≥45岁的患者中有58例(50.0%)患有糖尿病(P = 0.002)。两组在高血压(P < 0.001)、心肌梗死(P < 0.001)、Gensini评分中位数(P < 0.001)、超声心动图射血分数(P < 0.001)和实验室数据中的空腹血糖(P = 0.006)方面存在统计学显著差异。与年轻组相比,老年组左前降支(LAD)动脉(P < 0.001)、右冠状动脉(RCA)(P < 0.001)、三支血管病变(P < 0.001)和双支血管病变(P = 0.044)的发生率更高;另一方面,<45岁患者的单支血管病变发生率更高(P < 0.001)。
与老年CAD患者相比,年轻CAD患者的风险特征和血管造影结果有所不同。年轻CAD患者往往为男性,有家族史阳性,但糖尿病或高血压较少。老年患者的三支血管病变、双支血管病变以及左前降支(LAD)动脉和右冠状动脉(RCA)受累情况较多。相比之下,<45岁年轻患者的单支血管病变发生率更高。