Gao Hui, Wang Yuan, Shen Aidong, Chen Hui, Li Hongwei
Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Int J Gen Med. 2021 Dec 4;14:9321-9331. doi: 10.2147/IJGM.S334327. eCollection 2021.
The prevalence of acute myocardial infarction (AMI) is increasing in young adults, especially in men. This study aims to compare the characteristics and explore the association between age and clinical outcomes in male adults who first experienced AMI.
A total of 2737 male patients with AMI were divided into three groups by age: <50, 50-65, and ≥65 years. Clinical characteristics and long-term results (all-cause and cardiac deaths, nonfatal MI, revascularization, nonfatal stroke, cardiac rehospitalization) were identified across different age subgroups. The association between age and the outcomes was assessed by Cox proportional hazard models.
This population was followed up for a median of 36.7 months. Patients <50 years had a lower prevalence of diabetes (19.4%) and previous stroke (1.8%), while they were more often to be smokers (77.1%), obese (26%), dyslipidemia (74.7%), and with the single-vessel disease (16.2%). The risk of cardiovascular and all-cause death in patients ≥65 years was higher than patients <50 years, which was noticed through competing risk regression analysis after adjusting for confounding factors (adjusted HR 3.24; 95% CI 2.26-4.22, =0.020 for cardiovascular death, adjusted HR 4.17; 95% CI 1.91-9.10, <0.001 for all-cause death).
In conclusion, although men who suffered from first AMI under the age of 50 had lower mortality, they had a higher burden of modifiable traditional risk factors. The management of modifiable lifestyles should be addressed to all young AMI patients.
急性心肌梗死（AMI）在年轻人中的患病率正在上升，尤其是在男性中。本研究旨在比较首次发生AMI的成年男性的特征，并探讨年龄与临床结局之间的关联。
总共2737例AMI男性患者按年龄分为三组：<50岁、50 - 65岁和≥65岁。确定不同年龄亚组的临床特征和长期结果（全因死亡和心源性死亡、非致命性心肌梗死、血运重建、非致命性卒中、心脏再住院）。通过Cox比例风险模型评估年龄与结局之间的关联。
该人群的中位随访时间为36.7个月。<50岁的患者糖尿病患病率（19.4%）和既往卒中患病率（1.8%）较低，而他们更常为吸烟者（77.1%）、肥胖者（26%）、血脂异常者（74.7%），且单支血管病变发生率（16.2%）较高。≥65岁患者的心血管死亡和全因死亡风险高于<50岁的患者，在调整混杂因素后通过竞争风险回归分析发现这一点（心血管死亡调整后HR 3.2；95%CI 2.26 - 4.22，P = 0.020；全因死亡调整后HR 4.17；95%CI 1.91 - 9.10，P < 0.001）。
总之，尽管50岁以下首次发生AMI的男性死亡率较低，但他们具有更高的可改变传统危险因素负担。应针对所有年轻AMI患者进行可改变生活方式的管理。
