Sawada Hiroaki, Ando Hirohiko, Takashima Hiroaki, Waseda Katsuhisa, Shimoda Masahiro, Ohashi Hirofumi, Suzuki Akihiro, Sakurai Shinichiro, Nakano Yusuke, Amano Tetsuya
Department of Cardiology, Aichi Medical University, Japan.
Intern Med. 2020 May 1;59(9):1125-1131. doi: 10.2169/internalmedicine.4138-19. Epub 2020 Feb 12.
Objective Although acute coronary syndrome (ACS) is an uncommon entity in young patients, it constitutes an important problem due to the devastating effects of the disease on the more active lifestyle of young patients. At present, there are no guidelines regarding the prevention of ACS in young patients. Methods We performed a retrospective study of ACS patients between 2014 and 2017. Epidemiological data, clinical findings, and short-term outcomes were evaluated between young ACS patients (≤50 years old) and elderly ACS patients (>50 years old). Results Of a total of 361 consecutive ACS patients, 37 were young ACS patients (10.2%). Compared with elderly ACS patients, young ACS patients showed a higher prevalence of males (94.6% vs. 73.8%, p<0.001), current smoking (70.3% vs. 29.9%; p<0.001), and overweight persons (67.6% vs. 27.8%, p<0.001). The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio was significantly lower in young ACS patients than in elderly ACS patients [0.17 (0.12-0.25) vs. 0.25 (0.18-0.37), p=0.002]. The prevalence of cardio-pulmonary arrest and percutaneous cardiopulmonary support use was higher in young ACS patients than in elderly ACS patients (24.3% vs. 8.6%, p=0.003, 16.2% vs. 3.1%, p<0.001). Conclusion The features were markedly different between young ACS patients and elderly ACS patients. In young ACS patients, smoking, being overweight, and a low EPA/AA ratio were distinctive risk factors, and more serious clinical presentations were observed at the onset of ACS than in older patients.
目的 尽管急性冠状动脉综合征（ACS）在年轻患者中并不常见，但由于该疾病对年轻患者更积极的生活方式具有毁灭性影响，它构成了一个重要问题。目前，尚无关于年轻患者ACS预防的指南。方法 我们对2014年至2017年间的ACS患者进行了一项回顾性研究。评估了年轻ACS患者（≤50岁）和老年ACS患者（>50岁）之间的流行病学数据、临床发现和短期结局。结果 在总共361例连续的ACS患者中，37例为年轻ACS患者（10.2%）。与老年ACS患者相比，年轻ACS患者男性患病率更高（94.6%对73.8%，p<0.001）、当前吸烟者更多（70.3%对29.9%；p<0.001）以及超重者更多（67.6%对27.8%，p<0.001）。年轻ACS患者的二十碳五烯酸（EPA）/花生四烯酸（AA）比值显著低于老年ACS患者[0.17（0.12 - 0.25）对0.25（0.18 - 0.37），p = 0.002]。年轻ACS患者心肺骤停和使用经皮心肺支持的患病率高于老年ACS患者（24.3%对8.6%，p = 0.003，16.2%对3.1%，p<0.001）。结论 年轻ACS患者和老年ACS患者的特征明显不同。在年轻ACS患者中，吸烟、超重和低EPA/AA比值是独特的危险因素，并且与老年患者相比，ACS发病时观察到更严重的临床表现。
