Preview

Clinical Medicine (Russian Journal)

Advanced search

Myocardial infarction at a young age: risk factors, clinical presentation, features of management in the hospital

https://doi.org/10.30629/0023-2149-2021-99-1-58-62

Abstract

Aim: to study the risk factors, clinical peculiarities, diagnosis and treatment of young patients with myocardial infarction (≤ 44 years).

Material and methods. The research included 189 patients, who had MI in the period from January 1, 2015 to December 31, 2019 at the age of ≤ 44; 92.1% of patients were men. The average age of all patients was 41,2 (37.3; 43.6).

Results. Most frequent risk factors for the development of MI were: smoking — in 77.8%, essential hypertension — in 73.5%, burdened inheritance — in 49.2%, obesity — in 39.7% and pancreatic diabetes — in 10.6% of all cases. ST segment elevation was registered on the electrocardiogram in 87,8% of patients; 4.2% of them had only thrombolytic therapy; thrombolytic therapy was followed by coronarography with the intention of performing percutaneous coronary intervention (PCI) in 30.7% of cases; coronarography with the intention of performing primary PCI was applied to 54.2% of patients. PCI was performed in 76.5% of patients. 12.2% of patients had acute coronary syndrome without ST-segment elevation, and 95.7% of them had coronarography with the intention of performing percutaneous coronary intervention. PCI was performed in 73.9% of patients. Assignment frequency of beta-adrenergic blocking agent prescription was 95,2% (178 out of 187), аngiotensin-convertingenzyme inhibitors and sartans — 95.2% (178 out of 187), statins — 99.5% (188 of 189), dual antiplatelet therapy — 99.5% (188 out of 189), mineral corticoid receptor antagonists with ejection fraction of left ventricle of heart ≤ 40% — 28.6% (2 of 7).

Conclusion. The conducted research aims at the discussion of the vital topic of young patients with myocardial infarction management. It focuses on risk factors, clinical and angiographic presentation, and secondary prevention.

About the Authors

V. I. Denisov
Ryazan State Medical University
Russian Federation

390026, Ryazan



K. G. Pereverzeva
Ryazan State Medical University
Russian Federation

Pereverzeva Kristina G.— MD, PhD, Associate Professor, Chair of Hospital Therapy

390026, Ryazan



D. Y. Boyakov
Ryazan State Medical University
Russian Federation

390026, Ryazan



A. D. Chuchunov
Ryazan State Medical University
Russian Federation

390026, Ryazan



D. A. Khazov
Ryazan State Medical University
Russian Federation

390026, Ryazan



References

1. Townsend N., Nichols M., Scarborough P. et al. Cardiovascular disease in Europe — epidemiological update 2015. Eur. Heart. J. 2015;36(40):2696–705. DOI: 10.1093/eurheartj/ehv428

2. Jortveit J., Pripp A.H., Langørgen J. et al. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart. 2020;106:1420–1426. DOI:10.1136/heartjnl-2019-316067

3. Sulo G., Igland J., Nygård O., Vollset S.E. et al. Favourable trends in incidence of AMI in Norway during 2001–2009 do not include younger adults: a CVDNOR project. Eur. J. Prev. Cardiol. 2014Nov;21(11):1358–64. DOI: 10.1177/2047487313495993

4. Andersson C., Vasan R.S. Epidemiology of cardiovascular disease in young individuals. Nat. Rev. Cardiol. 2018;15:230–40. DOI:10.1038/nrcardio.2017.154

5. Danilov A.V., Kobzar I.I., Nagibin O.A. et al. Morbidity and mortality from cardiovascular diseases in Ryazan district: 2014–2018. Science of the young (Eruditio Juvenium). 2019;7(3):439–49. (in Russian.). DOI:10.23888/HMJ201973439-449

6. Gupta A., Wang Y., Spertus J.A. et al. Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J. Am. Coll. Cardiol. 2014;64(4):337–345. DOI: 10.1016/j.jacc.2014.04.054

7. Bangalore S., Fonarow G.C., Peterson E.D. et al. Get with the Guidelines Steering Committee and Investigators. Age and gender differences in quality of care and outcomes for patients with ST-segment elevation myocardial infarction. Am. J. Med. 2012;125(10):1000–9. DOI: 10.1016/j.amjmed.2011.11.016

8. Doughty M., Mehta R. et al. Acute myocardial infarction in the young. The University of Michigan experience. Am. Heart J. 2002;143(1):56–62. DOI: 10.1067/mhj.2002.120300

9. Wittlinger T., Seifert C., Simonis G. et al. Prognosis in myocardial infarction of young patients: Results of a prospective registry. Int. J. Cardiol. 2020;300:1–6. DOI: 10.1016/j.ijcard.2019.10.037

10. Andreenko E.Yu., Yavelov I.S., Loukianov M.M. et al. Ischemic Heart Disease in Subjects of Young Age: Current State of the Problem. Prevalence and Cardio-Vascular Risk Factors. Kardiologiia. 2018;58(10):53–58. (in Russian). DOI:10.18087/cardio.2018.10.10184

11. Gulati R., Behfar A., Narula J. et al. Acute Myocardial Infarction in Young Individuals. Mayo Clin. Proc. 2020;95(1):136–156. DOI: 10.1016/j.mayocp.2019.05.001

12. Nadia A. Khan, Stella S. Daskalopoulou, Igor Karp et al. Sex Differences in Acute Coronary Syndrome Symptom Presentation in Young Patients. JAMA Intern. Med. 2013;173(20):1863–1871. DOI:10.1001/jamainternmed.2013.1014980

13. Lei L., Zeng Bin. Risk factor differences in acute myocardial infarction between young and older people: a systematic review and meta-analysis. Int. J. Cardiovasc. Sci. 2019;32(2):163–176. DOI:10.5935/2359-4802.20190004

14. Spatz E.S., Curry L.A., Masoudi F.A. et al. The Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) Classifi cation System: A Taxonomy for Young Women With Acute Myocardial Infarction. Circulation. 2015;132(18):1710– 8. DOI: 10.1161/CIRCULATIONAHA.115.016502

15. Clinical recommendations. Acute coronary syndrome without ST segment elevation electrocardiogram. Ministry of Health of the Russian Federation. 2020:1–152. (In Russian). [Electronic resource]. URL: http://cr.rosminzdrav.ru/schema/154_3.

16. 2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction. Russian Journal of Cardiology. 2020;25(11):4103. (In Russian). DOI:10.15829/1560-4071-2020-4103


Review

For citations:


Denisov V.I., Pereverzeva K.G., Boyakov D.Y., Chuchunov A.D., Khazov D.A. Myocardial infarction at a young age: risk factors, clinical presentation, features of management in the hospital. Clinical Medicine (Russian Journal). 2021;99(1):58-62. (In Russ.) https://doi.org/10.30629/0023-2149-2021-99-1-58-62

Views: 1033


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0023-2149 (Print)
ISSN 2412-1339 (Online)