Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Cardiology, Liaocheng People's Hospital, Shandong University, Liaocheng, 252000, Shandong, China.
BMC Cardiovasc Disord. 2023 Jul 17;23(1):353. doi: 10.1186/s12872-023-03392-8.
This study aimed to analysis the clinical characteristics and prognosis of acute STEMI in patients aged ≤ 45 years.
Seven hundred and one patients with STEMI from Liaocheng People's Hospital from January 2018 to March 2021 were included in this study. Clinical characteristics, management, and outcomes (average follow-up: 11.5 months) were compared between patients aged ≤ 45 years and those aged > 45 years.
Of the patients with STEMI who underwent primary percutaneous coronary intervention, 108 (15.4%) were aged ≤ 45 years. Compared to the older group, the younger patient group included more males, current smokers, and those with alcohol use disorder (AUD) or a family history of ischaemic heart disease (IHD). The culprit vessel in young patients was the left anterior descending (LAD) artery (60% vs. 45.9%, P = 0.031), which may have been due to smoking (odds ratio, 3.5; 95% confidence interval: 1.12-10.98, P = 0.042). Additionally, young patients presented with higher low-density lipoprotein and lower high-density lipoprotein levels than older patients; uric acid levels were also significantly higher in younger patients than that in the older group. Diabetes showed a trend toward major adverse cardiovascular events (MACE) in both groups; age and sex were both independent predictors of MACE in older patients.
More patients who were smokers, had AUD, or a family history of IHD were present in the young patient group. Hyperuricaemia (but not dyslipidaemia) was a prevalent risk factor in patients aged ≤ 45 years. Diabetes should be controlled to reduce cardiovascular events in young patients.
本研究旨在分析年龄≤45 岁的急性 ST 段抬高型心肌梗死（STEMI）患者的临床特征和预后。
本研究纳入了 2018 年 1 月至 2021 年 3 月聊城市人民医院收治的 701 例 STEMI 患者。比较了年龄≤45 岁和＞45 岁患者的临床特征、治疗和结局（平均随访时间：11.5 个月）。
在接受直接经皮冠状动脉介入治疗的 STEMI 患者中，有 108 例（15.4%）年龄≤45 岁。与年龄较大的患者相比，年轻患者组中男性、现吸烟者、有酒精使用障碍（AUD）或缺血性心脏病（IHD）家族史的患者比例更高。年轻患者的罪犯血管为左前降支（LAD）（60%比 45.9%，P=0.031），这可能与吸烟有关（优势比，3.5；95%置信区间：1.12-10.98，P=0.042）。此外，年轻患者的低密度脂蛋白水平较低，高密度脂蛋白水平较高，尿酸水平也明显高于老年患者。两组中糖尿病均与主要不良心血管事件（MACE）呈正相关；年龄和性别均是老年患者 MACE 的独立预测因素。
年轻患者组中，有更多的吸烟者、有 AUD 或 IHD 家族史的患者。高尿酸血症（而非血脂异常）是年龄≤45 岁患者的常见危险因素。应控制糖尿病以减少年轻患者的心血管事件。
