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Nazli SA, Rosman A, Mohd Kasim NA, Al-Khateeb A, Ul-Saufie AZ, Md Radzi AB, Ibrahim KS, Kasim SS, Nawawi H. Coronary risk factor profiles according to different age categories in premature coronary artery disease patients who have undergone percutaneous coronary intervention. Sci Rep 2024; 14:15326. [PMID: 38961082 PMCID: PMC11222582 DOI: 10.1038/s41598-024-53539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 02/01/2024] [Indexed: 07/05/2024] Open
Abstract
Many studies have investigated the coronary risk factors (CRFs) among premature coronary artery disease (PCAD) patients. However, reports on the proportion and CRFs of PCAD according to different age cut-offs for PCAD is globally under-reported. This study aimed to determine the proportion of PCAD patients and analyse the significant CRFs according to different age cut-offs among percutaneous coronary intervention (PCI)-treated patients. Patients who underwent PCI between 2007 and 2018 in two cardiology centres were included (n = 29,241) and were grouped into four age cut-off groups that defines PCAD: (A) Males/females: < 45, (B) Males: < 50; Females: < 55, (C) Males: < 55; Females: < 60 and (D) Males: < 55; Females: < 65 years old. The average proportion of PCAD was 28%; 9.2% for group (A), 21.5% for group (B), 38.6% and 41.9% for group (C) and (D), respectively. The top three CRFs of PCAD were LDL-c level, TC level and hypertension (HTN). Malay ethnicity, smoking, obesity, family history of PCAD, TC level and history of MI were the independent predictors of PCAD across all age groups. The proportion of PCAD in Malaysia is higher compared to other studies. The most significant risk factors of PCAD are LDL-c, TC levels and HTN. Early prevention, detection and management of the modifiable risk factors are highly warranted to prevent PCAD.
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Affiliation(s)
- Sukma Azureen Nazli
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia.
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
| | - Azhari Rosman
- Institut Jantung Negara (IJN), Kuala Lumpur, Malaysia
| | - Noor Alicezah Mohd Kasim
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Alyaa Al-Khateeb
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Ahmad Zia Ul-Saufie
- Faculty of Computer and Mathematical Sciences, Universiti Teknologi MARA, Selangor, Malaysia
| | | | | | - Sazzli Shahlan Kasim
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Cardiac Vascular and Lung Research Institute (CaVaLRI), Universiti Teknologi MARA, Selangor, Malaysia
| | - Hapizah Nawawi
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia.
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
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Yang J, Wang K, Wang W, Niu J, Liu X, Shen H, Sun Y, Ge H, Han H. The Effect of Sleep Quality on Coronary Lesion Severity and Prognosis in the Young Acute Coronary Syndrome Population. J Cardiovasc Dev Dis 2024; 11:68. [PMID: 38392281 PMCID: PMC10889764 DOI: 10.3390/jcdd11020068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to explore the effect of long-term (≥1 year) sleep quality on coronary lesion complexity and cardiovascular prognosis in young acute coronary syndrome (ACS) patients. We consecutively recruited young patients aged from 18 to 44 years old with first-episode ACS and significant epicardial stenosis on coronary angiography from January 2016 to January 2017. Coronary lesion complexity was evaluated based on SYNTAX scores. Long-term sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) (PSQI ≤ 5 and PSQI > 5 groups). The primary endpoints were major adverse cardiovascular events (MACEs). A total of 466 young ACS patients (93.13% male; median age, 41 years) were included. Poor sleepers (PSQI > 5) had higher SYNTAX scores. After adjusting for confounders, PSQI scores (continuous variables, OR: 1.264; 95%CI: 1.166-1.371; p < 0.001) and PSQI grade (binary variable, OR: 3.864; 95%CI: 2.313-6.394; p = 0.001) were significantly associated with an increased risk of complex coronary lesions. During a median follow-up of 74 months, long-term poor sleep quality (PSQI > 5) was significantly associated with an increased risk of MACEs (HR: 4.266; 95%CI: 2.274-8.001; p < 0.001). Long-term poor sleep quality was a risk factor for complex coronary lesions and has adverse effects on cardiovascular prognosis in the young ACS population.
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Affiliation(s)
- Jiaxin Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Kexin Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Wenjie Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jialong Niu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xiaoli Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Hua Shen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yan Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Hailong Ge
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
- Department of Cardiology, Beijing Geriatric Hospital, Beijing 100095, China
| | - Hongya Han
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Chachar TS, Noor HA, AlAnsari NF, Masood A, Alraee A, Amin H, Yousif N. Clinical Characteristics and Outcomes of ST-Elevation Myocardial Infarction in Young Patients: A Single-Center Experience. Cureus 2024; 16:e53688. [PMID: 38455833 PMCID: PMC10918498 DOI: 10.7759/cureus.53688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMI and had primary percutaneous coronary intervention (pPCI). Results In this study, 510 patients with STEMI receiving pPCI were included, of whom 95 (18%) were younger than 45 years. The young age group had more smokers (57.9% vs. 40.5%, p = 0.003), newly diagnosed dyslipidemia (41.1% vs. 25.5%, p = 0.004), and a positive family history of early coronary artery disease (CAD) (14.7% vs. 4.3%, p = <0.001). Traditional cardiovascular risk factors, such as diabetes mellitus, systemic hypertension, and dyslipidemia, were significantly less common in young patients. Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly less common in young patients at the one-year follow-up (2.1 vs. 8.4%, p = 0.05). Conclusion Young patients with STEMI are more often smokers with undiagnosed dyslipidemia and have a family history of CAD. MACCE at one year is significantly lower as compared to older patients, but it is not negligible. Public health efforts are needed to reduce the prevalence of modifiable risk factors among the susceptible population.
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Affiliation(s)
- Tarique S Chachar
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Husam A Noor
- Cardiology, Bahrain Defence Force Hospital, Awali, BHR
| | - Nouf F AlAnsari
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Abdulrahman Masood
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Abdulrahman Alraee
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Haitham Amin
- Interventional Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Nooraldaem Yousif
- Interventional Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
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Pinxterhuis TH, Ploumen EH, Doggen CJM, Hartmann M, Schotborgh CE, Anthonio RL, Roguin A, Danse PW, Benit E, Aminian A, Linssen GCM, von Birgelen C. First myocardial infarction in patients with premature coronary artery disease: insights into patient characteristics and outcome after treatment with contemporary stents. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2023; 12:774-781. [PMID: 37619976 PMCID: PMC10653666 DOI: 10.1093/ehjacc/zuad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/25/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
AIMS Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. The aim of the present study is to asess differences in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents between patients with premature and non-premature CAD. METHODS AND RESULTS We pooled and analysed the characteristics and clinical outcome of all patients with a first MI (and no previous coronary revascularization) at time of enrolment, in four large-scale drug-eluting stent trials. Coronary artery disease was classified premature in men aged <50 and women <55 years. Myocardial infarction patients with premature and non-premature CAD were compared. The main endpoint was major adverse cardiac events (MACE): all-cause mortality, any MI, emergent coronary artery bypass surgery, or clinically indicated target lesion revascularization. Of 3323 patients with a first MI, 582 (17.5%) had premature CAD. These patients had lower risk profiles and underwent less complex interventional procedures than patients with non-premature CAD. At 30-day follow-up, the rates of MACE [hazard ratio (HR): 0.22, 95% confidence interval (CI): 0.07-0.71; P = 0.005), MI (HR: 0.22, 95% CI: 0.05-0.89; P = 0.020), and target vessel failure (HR: 0.30, 95% CI: 0.11-0.82; P = 0.012) were lower in patients with premature CAD. At 1 year, premature CAD was independently associated with lower rates of MACE (adjusted HR: 0.50, 95% CI: 0.26-0.96; P = 0.037) and all-cause mortality (adjusted HR: 0.24, 95% CI: 0.06-0.98; P = 0.046). At 2 years, premature CAD was independently associated with lower mortality (adjusted HR: 0.16, 95% CI: 0.05-0.50; P = 0.002). CONCLUSIONS First MI patients with premature CAD, treated with contemporary stents, showed lower rates of MACE and all-cause mortality than patients with non-premature CAD, which is most likely related to differences in cardiovascular risk profile. TWENTE trials: TWENTE I, clinicaltrials.gov: NCT01066650), DUTCH PEERS (TWENTE II, NCT01331707), BIO-RESORT (TWENTE III, NCT01674803), and BIONYX (TWENTE IV, NCT02508714).
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Affiliation(s)
- Tineke H Pinxterhuis
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede 7512 KZ, The Netherlands
- Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Hallenweg 5, 7522 NH Enschede, The Netherlands
| | - Eline H Ploumen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede 7512 KZ, The Netherlands
- Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Hallenweg 5, 7522 NH Enschede, The Netherlands
| | - Carine J M Doggen
- Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Hallenweg 5, 7522 NH Enschede, The Netherlands
| | - Marc Hartmann
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede 7512 KZ, The Netherlands
| | | | - Rutger L Anthonio
- Department of Cardiology, Treant Zorggroep, Scheper Hospital, Emmen, The Netherlands
| | - Ariel Roguin
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera and B. Rappaport-Faculty of Medicine, Israel Institute of Technology, Haifa, Israel
| | - Peter W Danse
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Edouard Benit
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Gerard C M Linssen
- Department of Cardiology, Ziekenhuisgroep Twente, Almelo and Hengelo, The Netherlands
| | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Koningsplein 1, Enschede 7512 KZ, The Netherlands
- Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Hallenweg 5, 7522 NH Enschede, The Netherlands
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Khoja A, Andraweera PH, Lassi ZS, Ali A, Zheng M, Pathirana MM, Aldridge E, Wittwer MR, Chaudhuri DD, Tavella R, Arstall MA. Risk Factors for Early-Onset Versus Late-Onset Coronary Heart Disease (CHD): Systematic Review and Meta-Analysis. Heart Lung Circ 2023; 32:1277-1311. [PMID: 37777398 DOI: 10.1016/j.hlc.2023.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 10/02/2023]
Abstract
AIM We aimed to systematically compare literature on prevalence of modifiable and non-modifiable risk factors for early compared to late-onset coronary heart disease (CHD). METHODS PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol registered in PROSPERO CRD42020173216). Study quality was assessed using the National Heart, Lung and Blood Institute tool for observational and case-control studies. Review Manager 5.3 was used for meta-analysis. Effect sizes were expressed as odds ratio (OR) and mean differences (MD)/standardised MD (SMD) with 95% confidence intervals (CI) for categorical and continuous variables. RESULTS Individuals presenting with early-onset CHD (age <65 years) compared to late-onset CHD had higher mean body mass index (MD 1.07 kg/m2; 95% CI 0.31-1.83), total cholesterol (SMD 0.43; 95% CI 0.23-0.62), low-density lipoprotein (SMD 0.26; 95% CI 0.15-0.36) and triglycerides (SMD 0.50; 95% CI 0.22-0.68) with lower high-density lipoprotein-cholesterol (SMD 0.26; 95% CI -0.42--0.11). They were more likely to be smokers (OR 1.76, 95% CI 1.39-2.22) and have a positive family history of CHD (OR 2.08, 95% CI 1.74-2.48). They had lower mean systolic blood pressure (MD 4.07 mmHg; 95% CI -7.36--0.78) and were less likely to have hypertension (OR 0.47, 95% CI 0.39-0.57), diabetes mellitus (OR 0.56, 95% CI 0.51-0.61) or stroke (OR 0.31, 95% CI 0.24-0.42). CONCLUSION A focus on weight management and smoking cessation and aggressive management of dyslipidaemia in young adults may reduce the risk of early-onset CHD.
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Affiliation(s)
- Adeel Khoja
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Zohra S Lassi
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Mingyue Zheng
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maleesa M Pathirana
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Emily Aldridge
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Melanie R Wittwer
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Debajyoti D Chaudhuri
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, South Australia, Australia; Medical Specialties, Faculty of Health Sciences, The University of Adelaide, SA, Australia
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Bauer D, Neuberg M, Nováčková M, Kočka V, Toušek P. Pre-hospital delay, clinical characteristics, angiographic findings, and in-hospital mortality in young and middle-aged adults with acute coronary syndrome: a single-centre registry analysis. Eur Heart J Suppl 2023; 25:E33-E39. [PMID: 37234234 PMCID: PMC10206810 DOI: 10.1093/eurheartjsupp/suad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There are several differences between younger and older adults with acute coronary syndrome (ACS). However, few studies have evaluated these differences. We analysed the pre-hospital time interval [symptom onset to first medical contact (FMC)], clinical characteristics, angiographic findings, and in-hospital mortality in patients aged ≤50 (group A) and 51-65 (group B) years hospitalised for ACS. We retrospectively collected data from 2010 consecutive patients hospitalised with ACS between 1 October 2018 and 31 October 2021 from a single-centre ACS registry. Groups A and B included 182 and 498 patients, respectively. ST-segment elevation myocardial infarction (STEMI) was more common in group A than group B (62.6 and 45.6%, respectively; P < 0.001). The median time from symptom onset to FMC in STEMI patients did not significantly differ between groups A and B [74 (40-198) and 96 (40-249) min, respectively; P = 0.369]. There was no difference in the rate of sub-acute STEMI (symptom onset to FMC > 24 h) between groups A and B (10.4% and 9.0%, respectively; P = 0.579). Among patients with non-ST elevation acute coronary syndrome (NSTE-ACS), 41.8 and 50.2% of those in groups A and B, respectively, presented to the hospital within 24 h of symptom onset (P = 0.219). The prevalence of previous myocardial infarction was 19.2% in group A and 19.5% in group B (P = 1.00). Hypertension, diabetes, and peripheral arterial disease were more common in group B than group A. Active smoking was more common in group A than group B (67 and 54.2%, respectively; P = 0.021). Single-vessel disease was present in 52.2 and 37.1% of participants in groups A and B, respectively (P = 0.002). Proximal left anterior descending artery was more commonly the culprit lesion in group A compared with group B, irrespective of the ACS type (STEMI, 37.7 and 24.2%, respectively; P = 0.009; NSTE-ACS, 29.4 and 21%, respectively; P = 0.140). The hospital mortality rate for STEMI patients was 1.8 and 4.4% in groups A and B, respectively (P = 0.210), while for NSTE-ACS patients it was 2.9 and 2.6% in groups A and B, respectively (P = 0.873). No significant differences in pre-hospital delay were found between young (≤50 years) and middle-aged (51-65 years) patients with ACS. Although clinical characteristics and angiographic findings differ between young and middle-aged patients with ACS, the in-hospital mortality rate did not differ between the groups and was low for both of them.
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Affiliation(s)
- Dávid Bauer
- Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 1150/50, Prague 100 00 and Ruská 87, Prague 100 00, Czech Republic
| | - Marek Neuberg
- Medtronic Czechia, Partner of INTERCARDIS Project, Prosecká 852/66, 190 00 Prague, Czech Republic
| | - Markéta Nováčková
- Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 1150/50, Prague 100 00 and Ruská 87, Prague 100 00, Czech Republic
| | - Viktor Kočka
- Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 1150/50, Prague 100 00 and Ruská 87, Prague 100 00, Czech Republic
| | - Petr Toušek
- Department of Cardiology, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 1150/50, Prague 100 00 and Ruská 87, Prague 100 00, Czech Republic
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7
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Liu X, Sun L, Wen W, Qiu M, Luo J, Li W, Hao S, He M, Wu J, Hu Y, Huang Y. Association between the ratio of serum eicosapentaenoic acid to arachidonic acid and risk of coronary artery disease in young Chinese patients. Front Nutr 2022; 9:1019058. [PMID: 36407537 PMCID: PMC9668899 DOI: 10.3389/fnut.2022.1019058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Objective Long-chain (LC) omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may play an anti-inflammatory effect and decrease the risk of coronary artery disease (CAD). In contrast, omega-6 PUFA, mainly arachidonic acid (AA), has pro-inflammatory and pro-aggregatory effects, which may increase the risk of CAD. This study evaluated the associations between EPA, DHA, AA, and their ratios (EPA/AA and DHA/AA) with the risk of CAD in young Chinese patients. Methods A total of 182 young patients with CAD and 143 age-matched controls were included. Traditional cardiovascular risk factors were recorded. Serum EPA, DHA and AA were measured by ultra-performance liquid chromatography-mass spectrometry. Results The level of AA was significantly higher, while the level of EPA was lower in the CAD group than that in the control group. There was no significant difference in DHA level in the two groups. Both the ratios of EPA/AA and DHA/AA were lower in the CAD group than that in the control. Multivariate logistic regression analysis showed that higher serum AA level was associated with the increased risk of CAD, while EPA was a protective factor for CAD. There was no significant association between DHA level and the risk of CAD. Although both higher ratios of EPA/AA [per tertile increment, adjusted odds ratios (ORs) (OR) 0.356, 95% confidence intervals (CI) 0.247–0.513] and DHA/AA (adjusted OR = 0.465, 95%CI = 0.332–0.653) were associated with a lower risk of CAD in young patients. Receiver operating characteristic (ROC) curve analysis showed that compared with AA, the diagnostic value was increased in EPA/AA, but not in DHA/AA. Conclusion EPA, but not DHA may play a protective role in CAD, while AA may be associated with the increased risk of CAD in young Chinese patients. The ratio of EPA/AA can increase the predictive value for diagnosing CAD than EPA or AA alone.
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Affiliation(s)
- Xiong Liu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Lichang Sun
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Weixing Wen
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Min Qiu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Jianjing Luo
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Department of Internal Medicine, Zhaoqing Medical College, Zhaoqing, China
| | - Weiwen Li
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Shali Hao
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Mingli He
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Jiandi Wu
- Department of Cardiology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Yunzhao Hu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Yunzhao Hu,
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation Research, Guangzhou, China
- *Correspondence: Yuli Huang,
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8
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Sagris M, Antonopoulos AS, Theofilis P, Oikonomou E, Siasos G, Tsalamandris S, Antoniades C, Brilakis ES, Kaski JC, Tousoulis D. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res 2022; 118:2281-2292. [PMID: 34358302 DOI: 10.1093/cvr/cvab264] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 08/03/2021] [Indexed: 12/18/2022] Open
Abstract
Myocardial infarction (MI) among young adults (<45 years) represents a considerable proportion of the total heart attack incidents. The underlying pathophysiologic characteristics, atherosclerotic plaque features, and risk factors profile differ between young and older patients with MI. This review article discusses the main differences between the younger and elderly MI patients as well as the different pathogenic mechanisms underlying the development of MI in the younger. Young patients with MI often have eccentric atherosclerotic plaques with inflammatory features but fewer lesions, and are more likely to be smokers, obese, and have poor lifestyle, such as inactivity and alcohol intake. Compared to older MI patients, younger are more likely to be men, have familial-combined hyperlipidaemia and increased levels of lipoprotein-a. In addition, MI in younger patients may be related to use of cannabis, cocaine use, and androgenic anabolic steroids. Genomic differences especially in the pathways of coagulation and lipid metabolism have also been identified between young and older patients with MI. Better understanding of the risk factors and the anatomic and pathophysiologic processes in young adults can improve MI prevention and treatment strategies in this patient group. Awareness could help identify young subjects at increased risk and guide primary prevention strategies. Additional studies focusing on gene pathways related to lipid metabolism, inflammation, and coagulation are needed.
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Affiliation(s)
- Marios Sagris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Alexios S Antonopoulos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Panagiotis Theofilis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Evangelos Oikonomou
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Gerasimos Siasos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Sotirios Tsalamandris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Centre of Research Excellence, British Heart Foundation, Oxford, OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, OX3 9DU, UK
| | - Emmanouil S Brilakis
- Division of Cardiovascular Medicine, Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
| | - Juan C Kaski
- Division of Cardiovascular Medicine, Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK
| | - Dimitris Tousoulis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
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9
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Allouche E, Ghariani A, Ben Ahmed H, Fekih Romdhane H, Ouechtati W, Bezdah L. [Myocardial infarction in the young : clinical characteristics, therapeutic aspects and in-hospital complications.]. Ann Cardiol Angeiol (Paris) 2021; 71:90-94. [PMID: 34802668 DOI: 10.1016/j.ancard.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/04/2021] [Accepted: 10/26/2021] [Indexed: 11/18/2022]
Abstract
AIM OF THE STUDY The aim of our study was to assess the clinical, electrical, angiographic and therapeutic characteristics of young patients with acute myocardial infarction and to describe the prevalence of in-hospital complications. PATIENTS AND METHODS FromJanuary 2014 to May 2017, we retrospectively studied data of patients with acute myocardial infarction younger than 45 years old in the department of cardiology of Charles Nicolle hospital of Tunis. RESULTS We enrolled 108 patients in the study. The prevalence of myocardial infarction in young patients was 8.5%. The mean age was 39.5 ± 5.5 years with a sex-ratio of 11. The most frequent cardiovascular risk factors were smoking (88%) and dyslipidaemia (51.9%). We reported 75 cases of ST segment elevation myocardial infarction. Primary angioplasty was performed in 41.3% of cases while lytic therapy was administered for the rest of the patients. It was successful in 75% of cases. Among 33 patients who presented with non-ST segment elevation myocardial infarction, percutaneous coronary angioplasty was performed in 60.6% of patients while 15.2% have undergone coronary artery bypass surgery and 24.2% received medical treatment only. In-hospital complications occurred in 39.8% of cases. In-hospital mortality was 1.9 %. CONCLUSIONS Acute myocardial infarction in the young represents a serious health problem. Primary preventive measures aimed at preventing our youth from adopting tobacco use and developing dyslipidemia should be implemented to delay and even to avoid the onset of coronary artery disease.
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Affiliation(s)
- E Allouche
- Service de Cardiologie, Centre hospital-universitaire Charles Nicole, Tunis, Tunisie
| | - A Ghariani
- Service de Cardiologie, Centre hospital-universitaire Farhat Hached, Sousse, Tunisie.
| | - H Ben Ahmed
- Service de Cardiologie, Centre hospital-universitaire Charles Nicole, Tunis, Tunisie
| | - H Fekih Romdhane
- Service de Cardiologie, Centre hospital-universitaire Charles Nicole, Tunis, Tunisie
| | - W Ouechtati
- Service de Cardiologie, Centre hospital-universitaire Charles Nicole, Tunis, Tunisie
| | - L Bezdah
- Service de Cardiologie, Centre hospital-universitaire Charles Nicole, Tunis, Tunisie
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10
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Chen H, Zhang J, Lai J, Zhou Y, Lin X, Deng G, Zhang Z, Li L. Circulating retinol binding protein 4 levels in coronary artery disease: a systematic review and meta-analysis. Lipids Health Dis 2021; 20:89. [PMID: 34419052 PMCID: PMC8380323 DOI: 10.1186/s12944-021-01516-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/29/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Retinol binding protein 4 (RBP4) has been proposed to play a role in the pathophysiology of coronary artery disease (CAD), but previous findings on the association of RBP4 levels with CAD are inconsistent. METHODS A meta-analysis based on observational studies was conducted to evaluate the association between circulating RBP4 levels and CAD. Databases including PubMed, Web of Science, Embase, Google Scholar and ClinicalTrials.gov database were searched for eligible studies published up to 12 July 2021. Standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using the inverse variance heterogeneity (IVhet) and random-effects model for data with moderate and high heterogeneity (I2 > 30%) and data with low heterogeneity were analysed using a fixed-effects model (I2 ≤ 30%). Moreover, a bias-adjusted quality-effects model was generated, and the prediction interval was also calculated under the random-effects model. RESULTS Two nested case-control studies, one cohort study and twelve case-control studies with a total of 7111 participants were included. Circulating RBP4 levels in patients with CAD were comparable to those in the controls under the IVhet model (SMD: 0.25, 95% CI: - 0.29-0.79, I2: 96.00%). The quality-effects model produced consistent results. However, the association turned to be significant under the random-effect model (SMD: 0.46, 95% CI: 0.17-0.75, I2: 96.00%), whereas the 95% predictive interval (PI) included null values (95% PI: - 0.82-1.74). Subgroup analyses illustrated a positive relationship between CAD and RBP4 levels in patients with complications (SMD: 1.34, 95% CI: 0.38-2.29, I2: 96.00%). The meta-regression analysis revealed that the mean BMI of patients (P = 0.03) and complication status (P = 0.01) influenced the variation in SMD. CONCLUSIONS There was low-quality evidence that patients with CAD exhibited similar circulating RBP4 levels compared with controls, and high inter-study heterogeneity was also observed. Thus, RBP4 might not be a potential risk factor for CAD. Comparisons among different subtypes of RBP4 with larger sample size are needed in the future.
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Affiliation(s)
- Hengying Chen
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
- School of Public Health, Shantou University, Shantou, China
| | - Jiaying Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiayu Lai
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yingyu Zhou
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoping Lin
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Guifang Deng
- Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China.
- School of Public Health, Shantou University, Shantou, China.
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11
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Tung BW, Ng ZY, Kristanto W, Saw KW, Chan SP, Sia W, Chan KH, Chan M, Kong W, Lee R, Loh JP, Low AF, Poh KK, Tay E, Tan HC, Yeo TC, Loh PH. Characteristics and outcomes of young patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: retrospective analysis in a multiethnic Asian population. Open Heart 2021; 8:e001437. [PMID: 33441469 PMCID: PMC7812097 DOI: 10.1136/openhrt-2020-001437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE ST segment elevation myocardial infarction (STEMI) is associated with significant mortality leading to loss of productive life years, especially in younger patients. This study aims to compare the characteristics and outcomes of young versus older patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) to help focus public health efforts in STEMI prevention. METHODS Data from the Coronary Care Unit database of the National University Hospital, Singapore from July 2015 to June 2019 were reviewed. Patients were divided into young (<50 years old) or older (≥50 years old) groups. RESULTS Of the 1818 consecutive patients with STEMI who underwent PPCI, 465 (25.6%) were <50 years old. Young compared with older patients were more likely to be male, current smokers, of Indian ethnicity, have family history of ischaemic heart disease (IHD) and had lower 1 year mortality (3.4% vs 10.4%, p<0.0001). Although diabetes, hypertension or dyslipidaemia was less common among young patients, the prevalence of having any one of these risk factors was high in the range of 28% to 38%. Age was an independent predictor of mortality in the older but not younger patients with STEMI, and diabetes showed a trend towards mortality in both groups. CONCLUSION Young patients with STEMI are more often smokers, of Indian ethnicity and had family history of IHD, although cardiometabolic risk factors are also prevalent. Mortality is lower, but not negligible, among the young patients with STEMI. Public health efforts are needed to reduce the prevalence of these risk factors among the constitutionally susceptible population.
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Affiliation(s)
- Benjamin Wl Tung
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhe Yan Ng
- Cardiology, National University Heart Centre, Singapore
| | - William Kristanto
- Cardiology, National University Heart Centre, Singapore
- Cardiology, Ng Teng Fong General Hospital, Singapore
| | | | - Siew-Pang Chan
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Winnie Sia
- Cardiology, National University Heart Centre, Singapore
| | - Koo Hui Chan
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mark Chan
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular Research Institute, National University Health System, Singapore
| | - William Kong
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ronald Lee
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular Research Institute, National University Health System, Singapore
| | - Joshua P Loh
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Adrian F Low
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian Keong Poh
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Edgar Tay
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Huay Cheem Tan
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tiong-Cheng Yeo
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Poay Huan Loh
- Cardiology, National University Heart Centre, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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12
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Adilova IG, Abdurakhmanov MM, Abdurakhmanov ZM. [Influence of age factor and age-associated predictors on remote results of coronary artery bypass grafting]. ANGIOLOGII︠A︡ I SOSUDISTAI︠A︡ KHIRURGII︠A︡ = ANGIOLOGY AND VASCULAR SURGERY 2020; 26:161-167. [PMID: 33332319 DOI: 10.33529/angio2020414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study was undertaken to analyse long-term survival and its predictors, depending on age of patients who underwent isolated coronary aortic bypass grafting. Our study included a total of 177 consecutive patients operated on during 2014. For the purpose of statistical analysis, the patients were divided into two groups according to their age at the time of surgery: <60 years (n=96) and >60 years (n=81). The mean age in the groups <60 years and >60 years amounted to 54.5±2.9 years and 63.5±2.5 years, respectively. All data were obtained from the patients' medical histories, outpatient follow-up records, and operative reports. The average duration of follow-up in the overall cohort amounted to 5.1±1.7 years. Chronic obstructive pulmonary disease, peripheral artery disease, and acute impairment of cerebral circulation were of significantly less common occurrence in the younger patient cohort. However, the frequency of a body mass index of ≥30 kg/m2, unstable angina, previously endured myocardial infarction and left ventricular systolic dysfunction in the preoperative period appeared to be significantly higher in this population. At 5 years after surgery, freedom from survival amounted to 94.8% in patients younger than 60 years (5 patients) and to 90.1% (8 patients) in those aged 60 years and older (p<0.001). Based on the findings of a multivariate analysis, independent predictors of mortality turned out to be a history of myocardial infarction, chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, lesions of peripheral arteries and the trunk of the left coronary artery. The area under the receiver operating characteristic curve was 0.834 (p<0.001, 95% CI: 0.724-0.902). Despite the fact that coronary artery bypass grafting is an effective method of treatment of ischaemic heart disease for both groups, special attention should be paid to the development and improvement of preventive strategies aimed at decreasing the impact of specific risk factors for cardiovascular diseases such as diet, lifestyle, weight control, and more aggressive medical therapy in younger patients. It is necessary to elaborate a reasonable strategy and optimization of the choice of an optimal approach to myocardial revascularization for elderly patients with multivessel and truncal lesions of coronary arteries, which are potential risk factors of death in the postoperative period.
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Affiliation(s)
- I G Adilova
- Department of Cardiology, Tashkent Institute of Advanced Medical Training, Tashkent, Uzbekistan
| | - M M Abdurakhmanov
- Department of Surgical Diseases and Resuscitation, Bukhara State Medical Institute, Bukhara, Uzbekistan
| | - Z M Abdurakhmanov
- Department of Surgical Diseases and Resuscitation, Bukhara State Medical Institute, Bukhara, Uzbekistan
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13
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Wang J, Li L, Ma N, Zhang X, Qiao Y, Fang G, Li G, Zhong T. Clinical investigation of acute myocardial infarction according to age subsets. Exp Ther Med 2020; 20:120. [PMID: 33005246 PMCID: PMC7523297 DOI: 10.3892/etm.2020.9248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/17/2020] [Indexed: 11/05/2022] Open
Abstract
A growing number of 'Young' patients less than 40 years of age are being hospitalized with a diagnosis of acute myocardial infarction (AMI) due to increased prevalence of risk factors for atherosclerosis. The aim of this study was to compare clinical characteristics and performances of AMI between young and elderly patients. We conducted a retrospective study to compare AMI in young patients and elder patients. Based on the medical record databases in our hospital, we enrolled 114 'young' AMI patients (age ≤42 years) and 179 'elder' AMI patients (≥60 years), and then collected and analyzed their demographic information, clinical performances, and coronary angiography results. In the young AMI group, the proportion of male patients was higher than that in the elder AMI group (94.7 vs. 64.2%, P<0.05). Compared with the elder AMI patients, young patients had higher rates of smoking history and positive family medical history, but lower rates of hypertension and diabetes. Elder patients with AMI were more likely to develop various clinical performances, and multiple-branch lesions; however, young AMI patients had relatively fewer symptoms, and the tissue lesions were more limited. The clinical profiles of AMI in young patients were different from that in elder AMI patients. Specific interventions should be carried out to prevent and control the prevalence of AMI in the young population.
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Affiliation(s)
- Jianwei Wang
- ECG Room, Weifang Maternal and Child Health Hospital, Weifang, Shandong 261000, P.R. China
| | - Li Li
- ECG Room, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China
| | - Ning Ma
- ECG Room, Shengli Oilfield Central Hospital, Dongying, Shandong 257034, P.R. China
| | - Xiaohui Zhang
- ECG Room, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong 271000, P.R. China
| | - Yanyan Qiao
- ECG Room, Weihai Municipal Hospital, Weihai, Shandong 234200, P.R. China
| | - Guangjie Fang
- ECG Room, Tai'an Traditional Chinese Medicine Hospital, Tai'an, Shandong 271000, P.R. China
| | - Guoping Li
- ECG Room, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China
| | - Tao Zhong
- ECG Room, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
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14
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Ambroziak M, Niewczas-Wieprzowska K, Maicka A, Budaj A. Younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature atherosclerosis. BMC Cardiovasc Disord 2020; 20:410. [PMID: 32912162 PMCID: PMC7488448 DOI: 10.1186/s12872-020-01677-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Premature coronary artery disease is one of the most pressing global issues in modern cardiology. The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients aged < 50 years with myocardial infarction (MI) compared to that in patients aged ≥50 years with MI and to that in young people without MI (no-MI < 50). METHODS The studied group (MI < 50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI ≥ 50) with MI aged 50-92 years and 240 healthy people aged 30-49 years without a history of MI (no-MI < 50). RESULTS There were statistically significant differences between the MI < 50 and MI ≥ 50 and no-MI < 50 groups regarding the family history of premature MI/ischaemic stroke and the percentage of patients with ≥2 relatives affected (10.8, 2.9, and 3.7%, respectively; p < 0.0001). There was a statistically significant difference in the patient age at the first MI occurrence among patients without a family history of premature CVD, those with 1 affected relative, and those with ≥2 affected first-degree relatives (56.6, 48.6 and 41.8 years, respectively) as well as those with affected first- and second-degree relatives (56.5, 50.7 and 47.0 years, respectively). CONCLUSIONS A younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature MI/ischaemic stroke. Thus, the family history of premature atherosclerosis involving not only first- but also second-degree relatives seems to be a valuable factor in CVD risk evaluation in young people.
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Affiliation(s)
- Michał Ambroziak
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Grenadierów 51/59, 04-730, Warsaw, Poland.
| | - Katarzyna Niewczas-Wieprzowska
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Grenadierów 51/59, 04-730, Warsaw, Poland
| | - Agnieszka Maicka
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Grenadierów 51/59, 04-730, Warsaw, Poland
| | - Andrzej Budaj
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Grenadierów 51/59, 04-730, Warsaw, Poland
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15
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Andreenko EY, Lukyanov MM, Yakushin SS, Vorobyev AN, Kudryashov EV, Yavelov IS, Klyashtorny VG, Pereverzeva KG, Boytsov SA, Drapkina OM. Young ambulatory patients with cardiovascular diseases: age and gender characteristics, comorbidity, medication and outcomes (according to RECVASA register). ACTA ACUST UNITED AC 2019. [DOI: 10.15829/1728-8800-2019-6-99-106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - M. M. Lukyanov
- National Medical Research Center for Preventive Medicine
| | | | | | | | - I. S. Yavelov
- National Medical Research Center for Preventive Medicine
| | | | | | | | - O. M. Drapkina
- National Medical Research Center for Preventive Medicine
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16
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Acute myocardial infarction among young adults under 40 years of age. Risk factors, clinical and angiographic characteristics. COR ET VASA 2019. [DOI: 10.33678/cor.2019.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Çanga Y, Emre A, Karataş MB, Çalık AN, Yelgeç NS, İnan D, Yüksel G, Terzi S. Prognostic value of serum uric acid levels in patients with non-STEMI undergoing percutaneous coronary intervention. Herz 2019; 45:389-396. [PMID: 31485775 DOI: 10.1007/s00059-019-04849-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/11/2019] [Accepted: 08/12/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Because myocardial infarction in young adults is rare, there has been limited research on the condition in this patient group. Very few data are available regarding the long-term outcomes of patients under 40 years of age with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing invasive treatments. The prognostic value of uric acid (UA) in young patients with NSTEMI who undergo percutaneous coronary intervention (PCI) has also not been studied. The purpose of this study was to evaluate the long-term clinical outcomes of this specific subset of young patients. In addition, we aimed to identify the role of serum UA in predicting the long-term prognosis of young patients with NSTEMI who have undergone PCI. METHODS We performed a retrospective analysis of 213 young adult patients (≤40 years old) with NSTEMI who underwent PCI during their hospitalization at our tertiary referral center. RESULTS The mean age of the 213 patients was 36.8 ± 3.3 years (range, 21-40 years). The median follow-up was 930 days. Our patients were predominantly male (88.3%) and the most frequent traditional cardiovascular risk factors were smoking and dyslipidemia. Baseline TIMI flow 0-1, estimated glomerular filtration rate (eGFR), and UA were found to be independently correlated with long-term major adverse cardiovascular events (MACEs) in multivariate Cox regression analysis. CONCLUSION In the present study, baseline TIMI flow 0-1, admission eGFR, and UA levels were correlated with MACEs during long-term follow-up in young patients with NSTEMI.
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Affiliation(s)
- Yiğit Çanga
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
| | - Ayşe Emre
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Mehmet Baran Karataş
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Ali Nazmi Çalık
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Nizamettin Selçuk Yelgeç
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Duygu İnan
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Gizem Yüksel
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
| | - Sait Terzi
- Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey
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18
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Duran M, Elçik D, Murat S, Öksüz F, Çelik İE. Risk factors for coronary artery disease in young patients with stable angina pectoris. Turk J Med Sci 2019; 49:993-998. [PMID: 31385674 PMCID: PMC7018258 DOI: 10.3906/sag-1905-56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background/aim We aimed to investigate the relationship between risk factors and the presence of coronary artery disease (CAD) in a young population with stable angina pectoris (SAP). Materials and methods A total of571 individuals younger than 60 years old, admitted to the outpatient clinic with chest pain and referred for coronary angiography between January 2015 and December 2017, were included in the study. All clinical and biochemical parameters were documented in the hospital records. Coronary angiography of patients was monitored from records. The individuals were divided into two groups. The patient group consisted of 363 individuals with at least one-vessel stenosis of ≥70%, and the control group consisted of 208 individuals with normal coronary angiography. We compared the traditional and nontraditional risk factors of these two groups in terms of the presence of CAD. Results Prevalence of male sex and smoking were higher in the patient group, and the prevalence of hypertension and diabetes were similar in the two groups. In the patient group, mean age, blood cholesterols, serum gamma-glutamyltransferase, hemoglobin, and white blood cell and lymphocyte levels were higher, while estimated glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C), platelets, and neutrophil/lymphocyte and platelet/lymphocyte ratios were lower. Low eGFR and HDL-C levels, older age, male sex, smoking, and high levels of low-density lipoprotein cholesterol and lymphocytes were independent risk factors for the presence of CAD in young patients. Conclusion Contrary to studies performed in the elderly, traditional and nontraditional risk factors could not exactly predict the presence of CAD in a young population with SAP.
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Affiliation(s)
- Mustafa Duran
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey
| | - Deniz Elçik
- Department of Cardiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sani Murat
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey
| | - Fatih Öksüz
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey
| | - İbrahim Ethem Çelik
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey
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Bacterial footprints in aspirate of infarct-related artery in ST-elevation myocardial infarction patients underwent primary percutaneous coronary intervention. Coron Artery Dis 2019; 30:494-498. [PMID: 31107692 DOI: 10.1097/mca.0000000000000751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Bacterial infections can trigger acute coronary syndromes. This study aimed to examine bacterial footprints in the aspirate of infarct-related artery. PATIENTS AND METHODS We studied 140 patients with ST-elevation myocardial infarction who underwent a primary coronary intervention using thrombus aspiration catheters. The aspirate was sent for bacteriological and pathological examinations and immunoassay for pneumolysin toxin. RESULTS Bacterial culture showed different bacteria in 14 samples. Leukocyte infiltrate was detected in all pathologically examined samples. Pneumolysin toxin was detected in only two samples. Patients with bacteria had similar baseline data as those without, except for the median age [46 (44-50) vs. 55 (47-62) years, P = 0.001, respectively], and white blood cells (WBCs) (16670 vs. 7550 cells/µl, P < 0.0001, respectively). In hospital-major clinical events (death, stroke, reinfarction, lethal arrhythmia, and heart failure) were not significantly different between the 2 groups with and without bacteria [4 (28.6%) vs. 20 (18.6%) events, respectively, odds ratio (OR) 1.8 (95% CL: 06-6.3), P = 0.5]. Patients with bacteria, heavy infiltration, and pneumolysin had insignificant higher events compared with those without [10/35 (28.6%) vs. 16/105 (15.2%) events, OR 2.2 (95% CL: 0.92-5.43), P = 0.13]. However, the difference was not significant. By multivariate analysis, bacteria, leukocyte infiltration, and pneumolysin were not predictors for in-hospital clinical events. Higher WBCs and younger age were significant predictors of bacterial footprints (P < 0.0001 and P = 0.04, respectively). CONCLUSION Bacterial footprints existed in the aspirate of infarct-related artery of ST-elevation myocardial infarction patients. Predictors were higher WBCs and younger age. Bacterial markers were not predictors for in-hospital clinical events. The presence of bacterial footprints supports the infectious hypothesis of atherosclerosis.
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Thunders M, Holley A, Harding S, Stockwell P, Larsen P. Using NGS-methylation profiling to understand the molecular pathogenesis of young MI patients who have subsequent cardiac events. Epigenetics 2019; 14:536-544. [PMID: 30971167 DOI: 10.1080/15592294.2019.1605815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Globally, ischaemic heart disease is a major contributor to premature morbidity and mortality. A significant number of young Myocardial Infarction (MI) patients (aged <55 y) have subsequent cardiac events within a year of their index event. This study used Next Generation Sequencing (NGS) methylation to understand the pathogenesis in this subset of young MI patients, comparing them to a cohort of patients without recurrent events. Cases and controls were matched for age, gender, ethnicity, and comorbidities. Differential methylation analyses were performed on Reduced Representation Bisulphite Sequencing (RRBS) data. Across the group and within case-control pairs' variation were analysed. Pairwise comparisons across each matched case-control pair resulted in a list of genes that were consistently significantly differentially methylated between all 16 matched pairs. This gene list was input into pathway analysis databases. Of particular relevance to cardiac pathology the following pathways were identified as over-represented in the patients with recurrent events; cell adhesion, transcription regulation and cardiac electrical conduction, specifically relating to calcium channel activity. This study looked at methylation differences between two populations of young MI patients. There were significantly different methylation profiles between the two groups studied; key pathways were identified as specifically affected in the patients with recurrent cardiac events. Matched pairwise comparisons and detailed interpretations of DNA methylation data may help to elucidate complex pathogeneses within and between clinical subtypes. Further analysis will determine whether these epigenomic differences can be useful as predictive biomarkers of clinical progression.
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Affiliation(s)
- Michelle Thunders
- a Department of Pathology (UOW) , University of Otago , Wellington , New Zealand
| | - Ana Holley
- b Wellington Cardiovascular Research Group, University of Otago , Willington , New Zealand
| | - Scott Harding
- c Department of Cardiology , Wellington Cardiovascular Research Group , New Zealand
| | - Peter Stockwell
- d Department of Biochemistry , University of Otago , Dunedin , New Zealand
| | - Peter Larsen
- b Wellington Cardiovascular Research Group, University of Otago , Willington , New Zealand
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Morovatdar N, Bondarsahebi Y, Khorrampazhouh N, Hozhabrossadati SA, Tsarouhas K, Rezaee R, Esfehani RJ, Poorzand H, Sahebkar A. Risk Factor Patterns for Premature Versus Late-Onset Coronary Artery Disease in Iran: A Systematic Review and Meta-Analysis. Open Cardiovasc Med J 2019. [DOI: 10.2174/1874192401913010005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background:
There are few data regarding the risk factors of premature vs late-onset Coronary Artery Disease (CAD). This study systematically reviews these risk factors in Iranian people.
Methods:
Medline, Web of Science, Embase and SID (Scientific Information Database; www.sid.ir) databases were searched for studies comparing CAD risk factors in young and older patients in Iran. Data extracted and pooled odds ratio (OR) with 95% Confidence Interval (CI) for each risk factor were calculated. Publication bias was evaluated by Egger’s test.
Results:
Seven studies (9080 participants) were included in the meta-analysis; analysis was carried out independently for each risk factor. Smoking (Odds Ratio (OR): 2.57, 95% CI: 1.96-3.37; p=<0.001), family history of CAD (OR: 2.45: 95% CI, 1.44-4.15, p<0.001), opium abuse (OR: 2.44: 95% CI, 1.22-4.88; p=0.001) and hyperlipidaemia (OR: 1.4: 95% CI, 1.13-1.73; p=0.001) were more common in premature CAD compared with older CAD patients. In contrast, diabetes mellitus (OR: 0.54: 95% CI, 0.39-0.73; p=0.0001) and hypertension (OR: 0.36, 95% CI: 0.21-0.59; p<0.001) were less prevalent.
Conclusion:
Risk factors were significantly different between premature and late-onset CAD. Policies regarding smoking and opium cessation and controlling hyperlipidaemia may be useful for the prevention of premature CAD in Iran.
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Gamma-Glutamyltransferase and Risk of Acute Coronary Syndrome in Young Chinese Patients: A Case-Control Study. DISEASE MARKERS 2018; 2018:2429160. [PMID: 30245751 PMCID: PMC6139227 DOI: 10.1155/2018/2429160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/28/2018] [Accepted: 07/24/2018] [Indexed: 01/14/2023]
Abstract
Background Serum gamma-glutamyltransferase (GGT) is a biomarker of hepatic disease. Recent studies have shown that GGT may also associate with the risk of coronary artery disease. However, the underlying mechanisms of this association are still unclear. Methods This study included 216 young patients with acute coronary syndrome (aged ≤55years) and 227 age-matched controls with normal findings by coronary angiography or coronary computed tomography angiography. We use standard colorimetric techniques and sandwich enzyme-linked immunosorbent assay to measure the levels of GGT and oxidized low-density lipoprotein (ox-LDL), respectively. Traditional risk factors of coronary artery disease, including smoking, diabetes mellitus, hypertension, dyslipidemia, and obesity/overweight, were evaluated according to the current guidelines. Results The levels of GGT were significantly correlated with body mass index and levels of triglyceride, fasting plasma glucose, aspartate aminotransferase, and ox-LDL (all P < 0.05). Multivariate logistic regression analysis showed that GGT was significantly associated with the risk of acute coronary syndrome in young Chinese patients (OR = 1.53, 95% CI = 1.09–2.15) after adjusting for traditional risk factors, including sex, age, quantity of smoking, hypertension, diabetes, body mass index, dyslipidemia, and high-sensitivity C-reactive protein. However, this association was significantly attenuated (OR = 1.20, 95% CI = 0.91–1.58) after further adjusting for the levels of ox-LDL. Conclusions GGT was associated with the risk of ACS in relatively young patients. The link between GGT and the risk of ACS may be dependent on ox-LDL levels, indicating that the prooxidant action is an important pathway for GGT in the development of cardiovascular disease.
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Balogh L, Katona É, Mezei ZA, Kállai J, Gindele R, Édes I, Muszbek L, Papp Z, Bereczky Z. Effect of factor XIII levels and polymorphisms on the risk of myocardial infarction in young patients. Mol Cell Biochem 2018; 448:199-209. [PMID: 29484525 DOI: 10.1007/s11010-018-3326-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/07/2018] [Indexed: 01/24/2023]
Abstract
Factor XIII (FXIII) stabilizes and protects the fibrin network. Its role in myocardial infarction (MI) is still to be clarified. To evaluate the association of FXIII levels with MI in young patients and to investigate how the FXIII-A p.Val34Leu, FXIII-B p.His95Arg, and IVS11, c.1952 + 144 C>G (Intron K) polymorphisms influence FXIII levels and MI risk. Patients with ST elevation MI below 40 years of age (MI, n = 119), age-matched clinical controls (CC, n = 101) without MI and coronary artery disease, and healthy controls (HC, n = 120) were investigated for FXIII activity, FXIII-A2B2, FXIII-B concentrations and for the polymorphisms. FXIII activity and FXIII-A2B2 antigen were significantly elevated in MI. FXIII activity and antigen were significantly elevated in Arg95, while decreased in Intron K "G" carriers. Smoking had an independent increasing effect on FXIII activity and FXIII-A2B2 antigen. Intron K C>G polymorphism significantly decreased the risk of MI in patients with elevated fibrinogen. Among the investigated factors Intron K C>G polymorphism and smoking have the most powerful effect on FXIII levels and on the risk of MI in the young. The effect of smoking on coronary thrombus formation may partially be attributed to its FXIII increasing effect.
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Affiliation(s)
- László Balogh
- Department of Cardiology, Faculty of Medicine, University of Debrecen, 22, Móricz Zs. krt., Debrecen, 4032, Hungary.
| | - Éva Katona
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
| | - Zoltán A Mezei
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
| | - Judit Kállai
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
| | - Réka Gindele
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
| | - István Édes
- Department of Cardiology, Faculty of Medicine, University of Debrecen, 22, Móricz Zs. krt., Debrecen, 4032, Hungary
| | - László Muszbek
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary.,Vascular Biology, Thrombosis and Hemostasis Research Group of the Hungarian Academy of Sciences, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
| | - Zoltán Papp
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 22, Móricz Zs. krt., Debrecen, 4032, Hungary
| | - Zsuzsanna Bereczky
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 98, Nagyerdei krt., Debrecen, 4032, Hungary
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The Impact of Age on Clinical Outcomes of Coronary Artery Bypass Grafting: Long-Term Results of a Real-World Registry. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9829487. [PMID: 29423414 PMCID: PMC5750486 DOI: 10.1155/2017/9829487] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 09/26/2017] [Accepted: 10/19/2017] [Indexed: 11/17/2022]
Abstract
The aim of this retrospective multicenter registry study was to investigate age-dependent trends in mortality, long-term survival, and comorbidity over time in patients who underwent isolated CABG from 2003 to 2015. The percentage of patients < 60 years of age was 18.9%. Female sex, chronic pulmonary disease, extracardiac arteriopathy, and neurologic dysfunction disease were significantly less frequent in this younger population. The prevalence of BMI ≥ 30, previous myocardial infarction, preoperative severe depressed left ventricular ejection fraction, and history of previous PCI were significantly higher in this population. After PS matching, at 5 years, patients < 60 years of age reported significantly lower overall mortality (p < 0.0001), cardiac-related mortality (p < 0.0001), incidence of acute myocardial infarction (p = 0.01), and stroke rates (p < 0.0001). Patients < 60 years required repeated revascularization more frequently than older patients (p = 0.05). Patients < 60 who underwent CABG had a lower risk of adverse outcomes than older patients. Patients < 60 have a different clinical pattern of presentation of CAD in comparison with more elderly patients. These issues require focused attention in order to design and improve preventive strategies aiming to reduce the impact of specific cardiovascular risk factors for younger patients, such as diet, lifestyle, and weight control.
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Lipoprotein-associated phospholipase A2 and oxidized low-density lipoprotein in young patients with acute coronary syndrome in China. Sci Rep 2017; 7:16092. [PMID: 29170433 PMCID: PMC5701077 DOI: 10.1038/s41598-017-16464-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022] Open
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered to be a risk factor for acute coronary syndrome (ACS), but this remains controversial. This study investigated the role of Lp-PLA2 in young Chinese patients with ACS. 228 young patients (aged ≤55 years) with ACS and 237 age-matched controls were included. Lp-PLA2 and oxidized low-density lipoprotein (ox-LDL) levels were measured by sandwich enzyme-linked immunosorbent assay. Lp-PLA2 levels were significantly correlated with smoking, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and ox-LDL levels (all P < 0.05). Multivariate logistic regression analysis showed that male sex (OR = 3.25, 95%CI = 1.26–8.38), smoking (OR = 3.50, 95%CI = 1.75–7.0), triglyceride (OR = 1.76, 95%CI = 1.08–2.87), high sensitivity C-reactive protein (hs-CRP) (OR = 2.11, 95%CI = 1.14–3.90) and ox-LDL (OR = 2.98, 95%CI = 1.72–5.1) were independently associated with ACS risk in young patients. Lp-PLA2 was associated with risk of ACS in young patients when adjusted for traditional risk factors, including age, sex, diabetes, hypertension, smoking, TC, LDL-C, triglyceride and hs-CRP (OR = 1.98, 95%CI = 1.10–3.56). When further adjusted for ox-LDL levels, the association between Lp-PLA2 and ACS became insignificant (OR = 1.69, 95%CI = 0.90–3.17). Lp-PLA2 was a marker of oxidative stress and inflammation, rather than an independent risk factor for ACS in young Chinese patients.
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Soluble Urokinase Plasminogen Activator Receptor and the Risk of Coronary Artery Disease in Young Chinese Patients. DISEASE MARKERS 2017; 2017:4719403. [PMID: 29109596 PMCID: PMC5646332 DOI: 10.1155/2017/4719403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 09/20/2017] [Indexed: 01/14/2023]
Abstract
Background Soluble urokinase plasminogen activator receptor (suPAR) is a novel marker of chronic inflammation and is considered to be a risk factor for coronary artery disease (CAD) in Caucasians. This study investigated the role of suPAR in young Chinese patients with CAD. Methods The study involved a total of 196 consecutive young (age ≤ 55 years) patients with angiographically proven CAD and 188 age-matched non-CAD individuals as controls. Traditional risk factors were evaluated using conventional assays, and levels of suPAR were measured by sandwich enzyme-linked immunosorbent assays. Results Levels of suPAR were significantly correlated with age (r = 0.20, P = 0.04), smoking (r = 0.33, P = 0.008), body mass index (r = 0.21, P = 0.03), and high-sensitivity C-reactive protein (hs-CRP; r = 0.31, P = 0.01). Multivariate logistic regression analysis showed that male sex (odds ratio (OR) = 3.12; 95% confidence interval (CI) = 1.18–8.25, P = 0.02), smoking (OR = 3.41, 95% CI = 1.55–7.50, P = 0.002), triglyceride (OR = 1.89, 95% CI = 1.10–3.25, P = 0.02), high-sensitivity C-reactive protein (OR = 1.24, 95% CI = 1.02–0.03, P = 0.03), and suPAR (OR = 1.37, 95% CI = 1.09–1.72, P = 0.007) were independently associated with CAD risk in young patients. Conclusions SuPAR is a novel independent risk factor for CAD in young Chinese patients. Further studies evaluating the effect of anti-inflammatory treatment on the suPAR levels and the risk of CAD are needed.
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