Mahendiran Thabo, Hoepli André, Foster-Witassek Fabienne, Rickli Hans, Roffi Marco, Eberli Franz, Pedrazzini Giovanni, Jeger Raban, Radovanovic Dragana, Fournier Stephane
Department of Cardiology, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland.
AMIS Plus Data Center Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Eur J Prev Cardiol. 2023 Oct 10;30(14):1504-1512. doi: 10.1093/eurjpc/zwad077.
Modifiable cardiovascular risk factors (RFs) play a key role in the development of coronary artery disease. We evaluated 20-year trends in RF prevalence among young adults hospitalized with acute coronary syndromes (ACS) in Switzerland.
Data were analysed from the Acute Myocardial Infarction in Switzerland (AMIS) Plus registry from 2000 to 2019. Young patients were defined as those aged <50 years. Among 58 028 ACS admissions, 7073 (14.1%) were young (median 45.6 years, IQR 42.0-48.0), of which 91.6% had at least one modifiable RF and 59.0% had at least two RFs. Smoking was the most prevalent RF (71.4%), followed by dyslipidaemia (57.3%), hypertension (35.9%), obesity (21.7%), and diabetes (10.1%). Compared with older patients, young patients were more likely to be obese (21.7% vs. 17.4%, P < 0.001) and active smokers (71.4% vs. 33.9%, P < 0.001). Among young patients, between 2000 and 2019, there was a significant increase in the prevalence of hypertension from 29.0% to 51.3% and obesity from 21.2% to 27.1% (both Ptrend < 0.001) but a significant decrease in active smoking from 72.5% to 62.5% (Ptrend = 0.02). There were no significant changes in the prevalence of diabetes (Ptrend = 0.32) or dyslipidaemia (Ptrend = 0.067).
Young ACS patients in Switzerland exhibit a high prevalence of RFs and are more likely than older patients to be obese and smokers. Between 2000 and 2019, RF prevalence either increased or remained stable, except for smoking which decreased but still affected approximately two-thirds of young patients in 2019. Public health initiatives targeting RFs in young adults in Switzerland are warranted.
可改变的心血管危险因素在冠状动脉疾病的发生发展中起关键作用。我们评估了瑞士因急性冠状动脉综合征(ACS)住院的年轻成年人中危险因素流行率的20年趋势。
分析了瑞士急性心肌梗死(AMIS)Plus注册中心2000年至2019年的数据。年轻患者定义为年龄<50岁的患者。在58028例ACS入院患者中,7073例(14.1%)为年轻患者(中位年龄45.6岁,四分位间距42.0 - 48.0岁),其中91.6%至少有一项可改变的危险因素,59.0%至少有两项危险因素。吸烟是最常见的危险因素(71.4%),其次是血脂异常(57.3%)、高血压(35.9%)、肥胖(21.7%)和糖尿病(10.1%)。与老年患者相比,年轻患者更易肥胖(21.7%对17.4%,P < 0.001)和为当前吸烟者(71.4%对33.9%,P < 0.001)。在年轻患者中,2000年至2019年间,高血压患病率从29.0%显著升至51.3%,肥胖患病率从21.2%升至27.1%(趋势P值均<0.001),但当前吸烟率从72.5%显著降至62.5%(趋势P值 = 0.02)。糖尿病患病率(趋势P值 = 0.32)和血脂异常患病率(趋势P值 = 0.067)无显著变化。
瑞士年轻的ACS患者危险因素流行率高,且比老年患者更易肥胖和吸烟。2000年至2019年间,除吸烟率下降但2019年仍影响约三分之二的年轻患者外,危险因素流行率要么上升要么保持稳定。有必要在瑞士针对年轻成年人的危险因素开展公共卫生倡议。