Ranjan Ashis, Agarwal Rajat, Mudgal Shiv Kumar, Bhattacharya Sudip, Kumar Barun
Department of Cardiology, AIIMS Deoghar, Jharkhand, India.
Department of Cardiothoracic Surgery, AIIMS Deoghar, Jharkhand, India.
J Family Med Prim Care. 2024 Apr;13(4):1200-1205. doi: 10.4103/jfmpc.jfmpc_1639_23. Epub 2024 Apr 22.
The increasing incidence of acute myocardial infarction (AMI) among the young population represents a significant and emerging health concern, contributing substantially to both mortality and morbidity. Unlike myocardial infarctions occurring in older individuals, traditional risk factors such as diabetes and hypertension exhibit a weaker association in the younger demographic. Consequently, there is a pressing need for a deeper understanding of novel risk factors that contribute to AMI in young patients. In this review, we explore distinct risk factor profiles associated with young-onset AMI in comparison to older patients. Special attention is given to novel risk factors, examining their susceptibility factors and exploring preventive measures. The comprehensive risk profile of extremely young South Asians who develop early coronary arterial disease is not yet fully understood. There are many novel evolving risk factors associated with young AMI which need intervention to reduce morbidity and mortality. It has been seen that established inflammatory markers like lipoprotein (a), dyslipidaemia, long COVID, and new emerging risk factors like air pollution (micro- and nanoplastics), periodontitis, acute stress, energy drinks, misuse of recreational drugs may increase risk and influence treatment, and outcomes of AMI in this young population. Screening of emerging novel risk markers and their optimization is important in preventing young patients with AMI. The role of conventional risk factors should not be overlooked and should be treated aggressively. Sex and geographic-specific base approaches are required to reduce risk factors and prevent AMI in young. More prospective studies are needed to evaluate the increasing incidence of young AMI and its associated novel risk factors.
急性心肌梗死（AMI）在年轻人群中的发病率不断上升，这是一个重大且新出现的健康问题，对死亡率和发病率都有很大影响。与老年个体发生的心肌梗死不同，糖尿病和高血压等传统风险因素在年轻人群中的关联性较弱。因此，迫切需要更深入地了解导致年轻患者发生AMI的新风险因素。在本综述中，我们探讨了与老年患者相比，年轻发病AMI相关的不同风险因素特征。特别关注新风险因素，研究其易感因素并探索预防措施。极年轻的南亚人发生早期冠状动脉疾病的综合风险特征尚未完全明确。有许多与年轻AMI相关的新出现的风险因素需要干预，以降低发病率和死亡率。已经发现，诸如脂蛋白（a）、血脂异常、长期新冠等已确定的炎症标志物，以及空气污染（微塑料和纳米塑料）、牙周炎、急性应激、能量饮料、滥用娱乐性药物等新出现的风险因素，可能会增加年轻人群发生AMI的风险并影响治疗及预后。筛查新出现的风险标志物并对其进行优化，对于预防年轻AMI患者很重要。传统风险因素的作用不应被忽视，应积极进行治疗。需要采取针对性别和地域的基础方法来降低风险因素，预防年轻人发生AMI。需要更多前瞻性研究来评估年轻AMI发病率上升及其相关的新风险因素。
