Kaul U, Dogra B, Manchanda S C, Wasir H S, Rajani M, Bhatia M L
Am Heart J. 1986 Jul;112(1):71-5. doi: 10.1016/0002-8703(86)90680-0.
One hundred four patients (101 men, three women), under 40 years of age, with myocardial infarction (MI), underwent coronary arteriography. Eighty patients had significant obstructive coronary artery disease (CAD) (group 1), 23 had normal coronary arteries (group 2), and one patient had coronary ostial stenosis as a result of nonspecific aortoarteritis (group 3). Coronary risk factors in group 1 included smoking (76.2%), hypercholesterolemia (36.3%), hypertension (32.5%), positive family history (28.7%), and diabetes mellitus (5%). Multiple risk factors were frequent (56.2%). Smoking was common (p less than 0.01) and diabetes mellitus less frequent (p less than 0.05) as compared to older (greater than 40 years) patients with MI and arteriographically proved CAD. The frequency of one-, two-, and three-vessel disease was 33.7%, 26.2%, and 40%, respectively, in group 1. Group 2 patients were almost devoid of coronary risk factors. The only group 3 patient had left coronary ostial stenosis with no risk factors. Similar to their counterparts in developed countries, young Indian patients with MI and obstructive CAD have a high frequency of coronary risk factors, especially smoking and severe multiple-vessel disease. Since normal coronary arteriograms are also frequent in this setting, a detailed evaluation is recommended for purposes of prognosis and management.
104例40岁以下的心肌梗死（MI）患者（101例男性，3例女性）接受了冠状动脉造影。80例患者有明显的阻塞性冠状动脉疾病（CAD）（第1组），23例冠状动脉正常（第2组），1例患者因非特异性主动脉动脉炎导致冠状动脉开口狭窄（第3组）。第1组的冠状动脉危险因素包括吸烟（76.2%）、高胆固醇血症（36.3%）、高血压（32.5%）、家族史阳性（28.7%）和糖尿病（5%）。多种危险因素很常见（56.2%）。与年龄较大（大于40岁）的MI和冠状动脉造影证实有CAD的患者相比，吸烟很常见（p<0.01），而糖尿病较少见（p<0.05）。第1组单支、双支和三支血管病变的发生率分别为33.7%、26.2%和40%。第2组患者几乎没有冠状动脉危险因素。第3组唯一的患者有左冠状动脉开口狭窄，无危险因素。与发达国家的患者类似，年轻的印度MI和阻塞性CAD患者冠状动脉危险因素的发生率很高，尤其是吸烟和严重的多支血管病变。由于在这种情况下冠状动脉造影正常也很常见，因此建议进行详细评估以用于预后和管理。
