Tun Kyaw L, Phyu Zin M, Tint Nyein Thuzar, Naung Zin H, Aung Thit H
Department of Medicine, University of Medicine 1 Yangon, Yangon, MMR.
Department of Ophthalmology, University of Medicine 1 Yangon, Yangon, MMR.
Cureus. 2024 Oct 17;16(10):e71690. doi: 10.7759/cureus.71690. eCollection 2024 Oct.
Introduction Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with an increasing prevalence of acute myocardial infarction (AMI) among younger populations. Despite this rising trend, there are limited data from Myanmar on the clinical profile and associated risk factors for premature CAD in young adults. This study aims to investigate the clinical characteristics and predisposing risk factors for AMI in individuals aged 40 years and below, contributing to a better understanding of disease patterns in this population. Methods A cross-sectional descriptive study was conducted at the coronary care unit of Yangon General Hospital over a 12-month period from January 1, 2019, to December 31, 2019. A total of 59 young adults, diagnosed with AMI based on the Fourth Universal Definition of Myocardial Infarction, were included. Clinical data, laboratory investigations, and demographic characteristics were collected and analyzed. Results Among the 59 participants, 46 (78%) were male, and smoking was prevalent in 45 (76.3%) cases. Dyslipidemia was common, with 46 (77.9%) exhibiting low high-density lipoprotein (HDL) cholesterol levels and 27 (45.8%) having elevated total cholesterol. Hypertension was observed in 31 (52.5%) patients, and 32 (54.2%) reported a family history of premature atherosclerotic cardiovascular disease. Furthermore, 28 (47.5%) of the cohort were classified as overweight, and 26 (44.1%) demonstrated low levels of physical activity. Chest pain was universally reported by all 59 (100%) patients as the presenting symptom. ST-segment elevation myocardial infarction (STEMI) was the predominant type, affecting 47 (79.6%) patients, with anterior wall involvement in 36 (61%) cases. Conclusion The findings of this study reveal that AMI in young adults is more prevalent among males, with smoking and dyslipidemia being the most significant risk factors. The high prevalence of low physical activity, hypertension, and overweight status further underscores the need for early lifestyle interventions. These results can be directly applied to clinical practice and public health policy in Myanmar by prioritizing smoking cessation programs, improving dyslipidemia management, and promoting physical activity in young populations. Additionally, this study provides a foundation for further research to explore more specific risk factors and paves the way for broader studies focusing on young AMI cases in Myanmar.
引言
冠状动脉疾病(CAD)仍是全球发病和死亡的主要原因,急性心肌梗死(AMI)在年轻人群中的患病率呈上升趋势。尽管有这种上升趋势,但缅甸关于年轻成年人过早发生CAD的临床特征和相关危险因素的数据有限。本研究旨在调查40岁及以下个体发生AMI的临床特征和诱发危险因素,以更好地了解该人群的疾病模式。
方法
于2019年1月1日至2019年12月31日在仰光总医院冠心病监护病房进行了一项横断面描述性研究。共有59名根据心肌梗死第四次通用定义被诊断为AMI的年轻成年人纳入研究。收集并分析了临床数据、实验室检查结果和人口统计学特征。
结果
在59名参与者中,46名(78%)为男性,45名(76.3%)有吸烟习惯。血脂异常很常见,46名(77.9%)高密度脂蛋白(HDL)胆固醇水平低,27名(45.8%)总胆固醇升高。31名(52.5%)患者患有高血压,32名(54.2%)报告有早发性动脉粥样硬化性心血管疾病家族史。此外,队列中有28名(47.5%)被归类为超重,26名(44.1%)身体活动水平低。所有59名(100%)患者均普遍报告胸痛为首发症状。ST段抬高型心肌梗死(STEMI)是主要类型,影响47名(79.6%)患者,其中36名(61%)累及前壁。
结论
本研究结果表明,年轻成年人中的AMI在男性中更为普遍,吸烟和血脂异常是最重要的危险因素。身体活动水平低、高血压和超重状态的高患病率进一步凸显了早期生活方式干预的必要性。这些结果可直接应用于缅甸的临床实践和公共卫生政策,优先开展戒烟项目、改善血脂异常管理并促进年轻人群的身体活动。此外,本研究为进一步探索更具体的危险因素提供了基础,并为聚焦缅甸年轻AMI病例的更广泛研究铺平了道路。