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Ramphul K, Aggarwal S, Verma R, Lohana P, Sombans S, Ramphul Y, Mejias SG, Kumar D, Kwansa NA, Pekyi-Boateng PK. Acute myocardial infarction among teenagers in the United States between 2016 and 2020: a retrospective analysis from the National Inpatient Sample. Arch Med Sci Atheroscler Dis 2023; 8:e177-e181. [PMID: 38283925 PMCID: PMC10811542 DOI: 10.5114/amsad/168637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/21/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction There is a lack of data on the characteristics of teenagers admitted with acute myocardial infarction (AMI). Recent studies have hinted that with changes in lifestyle and easier access to substances of abuse, people may be prone to several cardiovascular complications at an earlier age. Material and methods Our analysis was based on the 2016-2020 National Inpatient Samples. Logistic models allowed us to investigate the adjusted odds ratios (aOR) of AMI among teenagers. We explored outcomes and complications such as cardiogenic shock, extracorporeal membrane oxygenation (ECMO), coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), and mortality in these patients. Results A total of 2170 cases of AMI were recorded between 2016 and 2020 (53.3 cases per 100,000 admissions among teenagers). Weekend admissions (26.3% vs. 20.9%, aOR = 1.298, p < 0.001), smokers (15.9% vs. 10.1%, aOR = 1.198, p = 0.007), cannabis users (18.9% vs. 8.4%, aOR = 1.558, p < 0.001), or cocaine users (5.3% vs. 0.6%, aOR = 4.84, p < 0.001) showed increased odds of recording a diagnosis of AMI. Females showed lower odds than males (32.7% vs. 65%, aOR = 0.264, 95% CI: 0.24-0.291, p < 0.001). Admissions were more likely among teenagers with hypertension (9.9% vs. 2.5%, aOR = 3.382, p < 0.001). Those not covered by Medicaid or private insurances were more likely to be admitted for AMI than Medicaid beneficiaries (12.4% vs. 8.2%, aOR = 1.278, p < 0.001). Finally, teenagers classified as Blacks showed higher odds than whites of being admitted for AMI (aOR = 1.37, p < 0.001). A total of 270 (12.5%) deaths were also noted. Conclusions Various characteristics among teenagers influence their risk for AMI. Further studies and campaigns on educating teenagers about risk factors may provide long-term benefits.
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Affiliation(s)
| | | | | | | | - Shaheen Sombans
- Department of Paediatrics, Bharati Vidyapeeth Univ Med College and Hosp, Hyderabad, India
| | | | | | - Deepak Kumar
- Department of Internal Medicine, Masafi Hospital, Fujairah, UAE
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Murugan J, Balasubramaniyan JV, Mathiyalagan PK, Ramesh Y, Selvam M, Charley C, Muralidharan H, Venati R, Dhanasekaran ID, Rajanandh MG. Characteristics and treatment analysis of young acute coronary syndrome patients in a tertiary care hospital: A cross-sectional retrospective study. Health Sci Rep 2023; 6:e1141. [PMID: 36875928 PMCID: PMC9976564 DOI: 10.1002/hsr2.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/06/2023] Open
Abstract
Background and Aims The prevalence of acute coronary syndrome (ACS) has been rising in the younger population worldwide. To fully comprehend the effects of the condition, it is crucial to examine the evolving characteristics and treatment options. The purpose of this study is to evaluate the characteristics and treatment analysis for young ACS patients in a tertiary care setting. Methods This cross-sectional, retrospective, single-center study included a random sample of patients who had been hospitalized for ACS over the period of a year. We collected and analyzed data on risk factors, diagnoses, angiographic patterns, and potential treatments. Results The study involved 198 young ACS patients in total. The majority of patients (57%) had no risk factors, and the majority of them (44%) had ST-elevation myocardial infarction (STEMI) as their diagnosis. The most common type (48%) was single-vessel disease (SVD). Statins and antiplatelet medications made up the majority of the patients' nonsurgical treatments (88% and 87%, respectively). A statistically significant difference exists between young and older ACS patients with gender (p < 0.01). However, it is not clinically relevant. Conclusion Men were the majority of young ACS patients, and STEMI, SVD were more prevalent. The majority of young ACS patients had no significant risk factors. To determine the risk factors of young ACS patients, a more thorough case-control study is critically needed.
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Affiliation(s)
- Jagannaathan Murugan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | | | - Praveen Kumar Mathiyalagan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Yashwanth Ramesh
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Meera Selvam
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Chris Charley
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Harini Muralidharan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Rishitha Venati
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Indrani Devi Dhanasekaran
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research Deemed to be University Porur, Chennai India
| | - Muhasarparur Ganesan Rajanandh
- Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences Deemed to be University Thandalam, Chennai India
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Son SA, Lee SC, Lee E, Lee JH. Traumatic coronary artery dissection misdiagnosed as stress-induced cardiomyopathy in a patient with multiple trauma. Trauma Case Rep 2022; 42:100698. [PMID: 36247881 PMCID: PMC9554819 DOI: 10.1016/j.tcr.2022.100698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Traumatic coronary artery dissection resulting from blunt trauma, is a relatively rare and life-threatening event. We present a case report of a 42-year-old male who presented with electrocardiogram abnormality and cardiac enzyme elevation following a fall from a height of 3 m. The patient was misdiagnosed with stress-induced cardiomyopathy because of the absence of clinical signs of acute coronary syndrome. The patient was subsequently diagnosed with traumatic coronary artery dissection using coronary angiography, and the relevance of the trauma was confirmed using intravascular ultrasonography (IVUS). Herein, we highlight that trauma team should maintain a high suspicion of traumatic coronary artery dissection, although the early recognition of traumatic coronary artery dissection can be difficult. Additionally, the importance of coronary angiography with IVUS modalities for the evaluation of traumatic coronary artery dissection is highlighted.
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Affiliation(s)
- Shin-Ah Son
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea
| | - Sang Cjeol Lee
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea
| | - Eunkyu Lee
- Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea,Corresponding author at: Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea.
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Al-Shahrani MS, Katbi FA, Al-Sharydah AM, AlShahrani SD, Alghamdi TM, Al-Sharidah MA. Differences in Clinical Nature and Outcome Among Young Patients Suffering from an Acute Coronary Syndrome. J Blood Med 2021; 12:1011-1017. [PMID: 34880700 PMCID: PMC8648084 DOI: 10.2147/jbm.s336050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Acute coronary syndrome (ACS) is a life-threatening cardiac disease identified by acute, regional reductions in coronary blood flow, resulting in myocardial ischemia, or infarction, and manifesting as discomfort in the chest area, neck, or arms. Frequently, ACS is provoked by an atherosclerotic plaque; therefore, coronary atherosclerosis is converted into a chronic disease to an acute medical emergency. The purpose of this study was to explore the differences among these variables in patients less than 45 years of age suffering from this major health problem compared to older adults admitted with an ACS diagnosis, and to adopt an optimized temporary management. Patients and Methods A retrospective chart review study was conducted on a total of 652 ACS patients admitted at King Fahad Hospital of the University (KFHU) between 2015 and 2020. The patients' medical records were utilized for obtaining demographic data, presenting symptoms, risk factors, and clinical outcomes. Results Overall, 652 patients were enrolled. Of these, 109 patients (16.7%) were under 45, with a mean age of 38 ± 7. Younger patients showed a higher rate of palpitation (23.9% versus. 13.6%; P = 0.019). A positive smoking history and a family history of CAD were seen more often in younger patients (42.2% vs 27.3%, P < 0.001; 22.9% vs 9.4%, P < 0.001, respectively). Older patients had greater renal impairment with higher creatinine (median = 1.10 mg/dl (range, 0.3-13.0) vs 1.0 (0.3-19.0; p = 0. 001), BUN (median = 16.0 (mange, 0.9-141.0) vs 12.0 (0.9-49.0); P < 0.001)). Younger patients had higher levels of LDL and total cholesterol (median 138c. 115; p < 0.001) and cholesterol (median 209 vs 178.5; p < 0.001). Hospital mortality was 0.9% in younger patients versus 7.4% in older patients (P = 0.004). Conclusion Palpitations, smoking, family history, higher LDL levels, and total cholesterol levels were more prevalent in adults younger than 45 years old with ACS. Impaired renal function, hypertension, and diabetes were more in older patients with ACS.
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Affiliation(s)
- Mohammad Saeed Al-Shahrani
- Department of Emergency, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia.,Department of Critical Care, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia
| | - Faisal Ahmad Katbi
- Department of Emergency, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia.,Department of Critical Care, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia
| | - Abdulaziz Mohammad Al-Sharydah
- Department of Diagnostic and Interventional Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia
| | - Saad Dhafer AlShahrani
- Department of Emergency, Royal Commission Hospital, Jubail City, Eastern Province, Saudi Arabia
| | - Talal Mosfer Alghamdi
- Department of Anesthesia, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia
| | - Mohammad Adnan Al-Sharidah
- Department of Emergency, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia
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Khan KA, Khan MN, Kumar R, Shah JA, Kumar D, Qayyum D, Saghir T, Shaikh AH, Shakeel OB, Karim M. Clinical Profile and Angiographic Pattern of Coronary Artery Disease in Young Patients with Acute Coronary Syndrome. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim of this study was to determine the clinical profile and angiographic pattern in young patients (≤35 years) who presented with Acute coronary syndrome (ACS) to cardiac catheterization lab of tertiary care. We prospectively recruited all young patients (≤35 years) who presented
to our center with ACS from August 2020 to December 2020 and underwent coronary angiography. The primary endpoint was clinical profile including demographics, co-morbidities and angiographic findings. The secondary endpoint was in-hospital and three months mortality. A total of 1742 patients
with ACS were presented to our hospital. Out of them 108 (6.2%) were ≤35 years of age. There were 86% Male, 76% fall in age group of 31–35 years. 65% were overweight. 83% were active smoker and 15% were tobacco chewer. 28% were hypertensive, 12% were diabetic and 8% were dyslipidemic.
ST elevation myocardial infarction (STEMI) was the most common presentation (91%) with Anterior STEMI was the most common location (70%). Most had single vessel disease (62%) with left anterior descending (LAD) artery being the most common culprit vessel (70%). Proximal LAD was the most common
site (62%) with type B lesion being the most common pattern of involvement (44%). In-hospital and at 3 months mortality was 1.9% and 4% respectively. Our findings suggest that young males were most common presenter with ACS, being overweight and smoking were the most common risk factors. Proximal
LAD involvement with type B lesion causing anterior STEMI was the most common angiographic finding.
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Affiliation(s)
- Kamran Ahmed Khan
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | | | - Rajesh Kumar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | - Jehangir Ali Shah
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | - Dileep Kumar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | - Danish Qayyum
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | - Tahir Saghir
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | | | - Osama Bin Shakeel
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
| | - Musa Karim
- National Institute of Cardiovascular Diseases (NICVD), Karachi, 75510, Pakistan
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Rizk T, Blankstein R. Not All Heart Attacks are Created Equal: Thinking Differently About Acute Myocardial Infarction in the Young. Methodist Debakey Cardiovasc J 2021; 17:60-67. [PMID: 34824682 PMCID: PMC8588727 DOI: 10.14797/mdcvj.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
Cardiovascular disease, particularly myocardial infarction, remains a major cause of morbidity and mortality among young individuals. Although myocardial infarctions have declined significantly in the general population, this decline has not been uniformly observed in younger cohorts. Young adults often have different risk factors, including a higher burden of tobacco use and substance abuse, and they are less likely to be treated with preventive therapies since they are often categorized as having low risk. This review examines the existing literature on myocardial infarction in young patients, with a focus on risk factors, therapeutic challenges, and opportunities for prevention.
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Affiliation(s)
- Theresa Rizk
- Duke University School of Medicine, Durham, North Carolina, US.,Brigham and Women's Hospital, Brookline, Massachusetts, US
| | - Ron Blankstein
- Brigham and Women's Hospital, Brookline, Massachusetts, US.,Harvard Medical School, Cambridge, Massachusetts, US
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7
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Yagel O, Shadafny N, Eliaz R, Dagan G, Leibowitz D, Tahiroglu I, Planer D, Amir O, Elbaz Greener G, Alcalai R. Long-Term Prognosis in Young Patients with Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention. Vasc Health Risk Manag 2021; 17:153-159. [PMID: 33907409 PMCID: PMC8064716 DOI: 10.2147/vhrm.s298436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Acute coronary syndrome (ACS) at a young age is uncommon. Limited data regarding the long-term follow-up and prognosis in this population are available. Our objectives were to evaluate the long-term clinical outcomes of patients presenting with ACS at a young age and to assess factors that predict long-term prognosis. Methods A retrospective analysis of consecutive young patients (male below 40 and female below 50 years old) that were admitted with ACS and underwent percutaneous coronary intervention (PCI) between the years 1997 and 2009. Demographics, clinical characteristics, and clinical outcomes including major cardiovascular (CV) events and mortality were analyzed. Multivariable cox proportional hazard model was performed to identify predictors of long-term prognosis. Results One-hundred sixty-five patients were included with a mean follow-up of 9.1±4.6 years. Most patients were men (88%), and mean age (years) was 36.8±4.2. During follow-up, 15 (9.1%) died, 98 (59.4%) patients had at least one major CV event, 22 (13.3%) patients had more than two CV events, and the mean number of recurrent CV events was 1.4±1.48 events per patient. In multivariate analysis, the strongest predictors of major CV events and/or mortality were coronary intervention without stent insertion (HR1.77; 95% CI 1.09-2.9), LAD artery involvement (HR 1.59; 95% CI 1.04-2.44) and hypertension (HR 1.6; 95% CI 1.0-2.6). Conclusion Patients with ACS in young age are at high risk for major CV and/or mortality in long-term follow-up with a high rate of recurrent CV events. Close follow-up and risk factor management for secondary prevention have a major role, particularly in this population.
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Affiliation(s)
- Oren Yagel
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naseem Shadafny
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ran Eliaz
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gil Dagan
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Leibowitz
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ilgar Tahiroglu
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Planer
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Offer Amir
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gabby Elbaz Greener
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronny Alcalai
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Qureshi WT, Kakouros N, Fahed J, Rade JJ. Comparison of Prevalence, Presentation, and Prognosis of Acute Coronary Syndromes in ≤35 years, 36 - 54 years, and ≥ 55 years Patients. Am J Cardiol 2021; 140:1-6. [PMID: 33166493 DOI: 10.1016/j.amjcard.2020.10.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
Whether very young patients (≤35-year-old) differ in the prevalence, presentation and prognosis of ACS is not well known. Of 43,446 patients who were referred to a tertiary care cardiac catheterization laboratory between January 1, 2006 and June 30, 2017, 26,545 patients were ACS (defined as ST Elevation MI, Non-ST Elevation MI or unstable angina pectoris). Detailed chart review was performed and characteristics at baseline were compared for ages ≤35 years, ages 36 to 54 years and ages ≥55 years. A total of 291 (1.1%) were ≤35-year-old, 7,649 (28.8) were 36 to 54-year-old and 18,605 (70.1%) were ≥55-year-old. ACS patients aged ≤35-year-old, were more likely to be men, Caucasian white, smoker, obese, and have family history of coronary artery disease and less likely to have comorbidities such as hypertension, diabetes mellitus, and hyperlipidemia compared with older patients. They were also more likely to present with elevated troponin levels than other groups. They also tended to present with late ST elevation myocardial infarction and were more likely to receive bare metal stents than older patients. The prevalence of 2- and 3-vessel disease was lower compared with older patients. They also had higher prevalence of cardiogenic shock. Compared with 36 to 54-year-old patients, ≤35-year-old were at significant higher risk of 30-day mortality in a multivariable adjusted regression model (Odds ratio 5.65, 95% confidence interval 2.49 to 12.82, p <0.001). Very young patients comprised ∼1% of all ACS cases but had much more prevalence of modifiable risk factors and significantly worse mortality. Modifying these risk factors may mitigate the risk in these patients and should be studied in the future.
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9
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Patanavanich R, Glantz SA. Association between tobacco control policies and hospital admissions for acute myocardial infarction in Thailand, 2006-2017: A time series analysis. PLoS One 2020; 15:e0242570. [PMID: 33264315 PMCID: PMC7710088 DOI: 10.1371/journal.pone.0242570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Studies in many countries have documented reductions of acute myocardial infarction (AMI) hospitalizations with smokefree policies. However, evidence on the association of cigarette tax with AMI events is unclear. There have been no studies of the associations between these two policies and AMI hospitalizations in Thailand. Methods We used negative binomial time series analyses of AMI hospitalizations (ICD-10 codes I21.0-I21.9), stratified by sex and age groups, from October 2006 to September 2017 to determine whether there was a change in AMI hospitalizations as a result of the changes in cigarette prices and the implementation of a 100% smokefree law. Results Cigarette price increases were associated with a significant 4.7% drop in AMI hospitalizations among adults younger than 45 (incidence rate ratio [IRR], 0.953; 95% confidence interval [CI], 0.914–0.993; p = 0.021). Implementation of the 100% smokefree law was followed by a significant 13.1% drop in AMI hospitalizations among adults younger than 45 (IRR, 0.869; 95% CI, 0.801–0.993; P = 0.001). There were not significant associations in older age groups. Conclusions The Thai cigarette tax policy and the smokefree law were associated with reduced AMI hospitalizations among younger adults. To improve effectiveness of the policies, taxes should be high enough to increase cigarette price above inflation rates, making cigarettes less likely to be purchased; smokefree laws should be strictly enforced.
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Affiliation(s)
- Roengrudee Patanavanich
- Center for Tobacco Control Research and Education, Department of Medicine, University of California San Francisco, San Francisco, California, United State of America
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, Department of Medicine, University of California San Francisco, San Francisco, California, United State of America
- * E-mail:
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10
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Belhadj M, Saadi S, Ben Jomaa S, Dhouieb R, Kort I, Marzougui M, Amine Mesrati M, Chadly A, Haj Salem N. [Death due to myocardial infarction in young patients: A study of 312 cases of sudden death]. Ann Cardiol Angeiol (Paris) 2020; 69:67-73. [PMID: 32222285 DOI: 10.1016/j.ancard.2020.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/04/2020] [Indexed: 06/10/2023]
Abstract
Sudden cardiac death in young is seen as a dramatic phenomenon requiring knowledge of its impact. We aim to study the epidemiological characteristics of sudden cardiac ischemic death in young, and to discuss his involvement in the occurrence of death. We performed a retrospective cohort study using autopsy data from the department of forensic medicine of the University Hospital of Fattouma Bourguiba, Monastir-Tunisia. A review of all autopsies performed during 23 years was done. In each case, clinical information and circumstances of death were obtained. We have included all sudden death in persons aged between 1 year and 35 years for the male and from one year to 45 years for female. We collected 312 cases of sudden death during the studied period. The collected data were processed using SPSS 20. The significance level was set at 0.05. Thirty-two cases of cardiac ischemic sudden death have been collected. Myocardial infarction was the second cause of sudden death in young patients. There was a male predominance. The most affected subjects were aged between 25-45 years. The death occurred more frequently at rest. Coronary artery disease has been discovered in twenty-four cases (75%). The myocardial infarction occurred on healthy coronary arteries in eight cases. An anomalous course of coronary arteries, in particular myocardial bridging, was found in eight cases (25%). Toxicological screening was negative in all cases. Identifying epidemiological characteristics of sudden cardiac ischemic death in this population is important for guiding approaches to prevention that must be based on dietary hygienic measures and the control of cardiovascular risk factors.
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Affiliation(s)
- M Belhadj
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - S Saadi
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - S Ben Jomaa
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - R Dhouieb
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - I Kort
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - M Marzougui
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - M Amine Mesrati
- Service de médecine légale, hôpital Taher Sfar Mahdia, Mahdia, Tunisie
| | - A Chadly
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie
| | - N Haj Salem
- Service de médecine légale, université de Monastir, hôpital universitaire Fattouma Bourguiba, Monastir, Tunisie.
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Zgheib H, Al Souky N, El Majzoub I, Wakil C, Sweidan K, Kaddoura R, Al Hariri M, Chebel RB. Comparison of outcomes in ST-elevation myocardial infarction according to age. Am J Emerg Med 2020; 38:485-490. [DOI: 10.1016/j.ajem.2019.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/03/2019] [Accepted: 05/09/2019] [Indexed: 01/23/2023] Open
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Patil R, Shetty L, Sheetal KC, Chandrashekar V, Vijaykumar JR, Patil V, Raveesh H. Clinical and angiographic profile of CAD in young smokers. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2020. [DOI: 10.4103/ijca.ijca_42_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Vautrin E, Jean ABP, Fourny M, Marlière S, Vanzetto G, Bouvaist H, Debaty G, Belle L, Danchin N, Labarère J. Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45. Catheter Cardiovasc Interv 2019; 96:1222-1230. [DOI: 10.1002/ccd.28627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/08/2019] [Accepted: 11/17/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Estelle Vautrin
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | | | - Magali Fourny
- Quality of Care Unit Grenoble Alpes University Hospital Grenoble France
| | - Stéphanie Marlière
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Gérald Vanzetto
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Hélène Bouvaist
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Guillaume Debaty
- TIMC, UMR 5525, CNRS Université Grenoble Alpes Grenoble France
- Department of Emergency Medicine Grenoble Alpes University Hospital Grenoble France
| | - Loïc Belle
- Department of Cardiology Annecy‐Genevois Hospital, Réseau nord alpin des urgences (RENAU) Annecy France
| | - Nicolas Danchin
- Department of Cardiology Hôpital Européen Georges Pompidou, Assistance Publique‐Hôpitaux de Paris Paris France
| | - José Labarère
- Quality of Care Unit Grenoble Alpes University Hospital Grenoble France
- TIMC, UMR 5525, CNRS Université Grenoble Alpes Grenoble France
- CIC 1406, INSERM Grenoble Alpes University Hospital Grenoble France
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Culprit lesion morphology in young patients with ST-segment elevated myocardial infarction: A clinical, angiographic and optical coherence tomography study. Atherosclerosis 2019; 289:94-100. [DOI: 10.1016/j.atherosclerosis.2019.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 01/24/2023]
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Beheshti S, Madsen CM, Varbo A, Nordestgaard BG. How To Identify Familial Premature Myocardial Infarction: Comparing Approaches To Identify Familial Hypercholesterolemia. J Clin Endocrinol Metab 2019; 104:2657-2667. [PMID: 30753598 DOI: 10.1210/jc.2018-02261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/04/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT How best to identify families with premature myocardial infarction is unclear. OBJECTIVE We compared approaches to identify familial premature myocardial infarction in the general population using different familial hypercholesterolemia (FH) criteria and low-density lipoprotein (LDL) cholesterol cut-points. DESIGN AND SETTING Clinical and mutation criteria for FH and LDL cholesterol cut-points were applied for identification of familial premature myocardial infarction in 106,732 individuals from the Copenhagen General Population Study. RESULTS FH criteria identified 898 (13%) cases with familial premature myocardial infarction, leaving 5856 (87%) cases undetected. The ORs for familial premature myocardial infarction, compared with the respective remainder groups, were 4.7 (95% CI, 3.7 to 6.0) for clinical FH by Dutch Lipid Clinic Network criteria, 4.4 (4.0 to 4.7) for Simon Broome criteria, 2.1 (95% CI, 1.7 to 3.6) for Make Early Diagnosis to Prevent Early Death criteria, 2.1 (95% CI, 1.4 to 3.3) for FH mutation, and 1.4 (95% CI, 1.3 to1.6) for LDL cholesterol ≥5 mmol/L (193 mg/dL). For these risk groups, the sensitivity (true positive rate) for identification of familial premature myocardial infarction were 1.3%, 13%, 1.6%, 0.9%, and 7.1%, respectively. Compared with universal screening of a similar fraction of the population, the relative increase in sensitivity for these risk groups was 3.8-fold [fraction of population examined: 0.3%, 3.3-fold (4%), 2.0-fold (0.8%), 2.0-fold (0.4%), and 1.4-fold (5.3%), respectively]. CONCLUSION Criteria for FH identify a small fraction of individuals with familial premature myocardial infarction in the general population. Actively identifying families with premature myocardial infarction would be of potential preventive importance, and this study provides data that could be used to choose the best method for such family identification.
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Affiliation(s)
- Sabina Beheshti
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian M Madsen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Varbo
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Premature Myocardial Infarction: Genetic Variations in SIRT1 Affect Disease Susceptibility. Cardiol Res Pract 2019; 2019:8921806. [PMID: 31143479 PMCID: PMC6501229 DOI: 10.1155/2019/8921806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/13/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives Premature myocardial infarction (PMI) is an uncommon disease, and its incidence varies between 2% and 10%, rising, depending on genetic susceptibility under the influence of lifestyle. The purpose of this study was to investigate the association between SIRT1 single nucleotide polymorphisms (SNPs), SIRT1, and eNOS (endothelial nitric oxide synthase) protein expressions, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) in young patients with premature ST-elevation myocardial infarction (STEMI). Methods Genotyping of the three single-nucleotide polymorphisms (rs7895833 A > G in the promoter region, rs7069102 C > G in intron 4, and rs2273773 C > T in exon 5) in SIRT1 gene was performed in 108 consecutive patients (87.0% were men with a mean age of 40.74 ± 3.82 years) suffering from ST-elevation myocardial infarction at the age of ≤45 and 91 control subjects. Results The risk for myocardial infarction was increased by 2.31 times in carriers of CC or CG genotypes. SIRT1 protein levels were enhanced and endothelial nitric oxide synthase levels were diminished in ST-elevation myocardial infarction patients regardless of the underlying gene variant. There was no correlation between SIRT1 expression and the amount of endothelial nitric oxide synthase, total antioxidant status, total oxidant status, and oxidative stress index levels in patients and in the control group either. Conclusions SIRT1 single-nucleotide polymorphisms were associated with premature myocardial infarction, which affected the SIRT1 and endothelial nitric oxide synthase protein expression, irrespective of the underlying SIRT1 genotype.
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Donovan AE, Bridwell RE, Carius B, Kot C, Oliver JJ. Traumatic coronary artery dissection leading to ventricular tachycardia. Am J Emerg Med 2019; 37:1007.e5-1007.e7. [PMID: 30819580 DOI: 10.1016/j.ajem.2019.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022] Open
Abstract
Traumatic coronary artery dissection is an unusual injury following trauma. It is potentially life threatening and requires prompt recognition on presentation. We present a case report of a 42-year-old male who presented with ventricular tachycardia following a high-speed motorcycle collision that was found to have a coronary artery dissection. The patient had multiple complications, highlighting the importance of early recognition of this disease process.
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Affiliation(s)
- Andrew E Donovan
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
| | - Rachel E Bridwell
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Brandon Carius
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Chloe Kot
- Carlisle High School, 623 W Penn Street, Carlisle, PA 17013, United States
| | - Joshua J Oliver
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
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18
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Okano R, Liou YJ, Yu HY, Wu IH, Chou NK, Chen YS, Chi NH. Coronary Artery Bypass in Young Patients-On or Off-Pump? J Clin Med 2019; 8:E128. [PMID: 30678203 PMCID: PMC6407132 DOI: 10.3390/jcm8020128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/12/2019] [Accepted: 01/20/2019] [Indexed: 11/29/2022] Open
Abstract
A definitive conclusion regarding whether on-pump or off-pump coronary artery bypass is preferable in young patients is lacking. The aim of our study was to perform a long-term comparison of the two approaches in young patients. We analyzed the National Health Insurance Research Database, using data for patients between 18 and 45 years of age who had undergone isolated coronary artery bypass between 2001 and 2011. The study endpoints were: all-cause death, major adverse cardiac and cerebrovascular events, and repeat revascularization within 30 days, 1 year, 5 years, and the entire 10-year follow-up period. A total of 344 patients received off-pump surgery and 741 patients received on-pump surgery. Preoperative characteristics and comorbidities were similar in both groups, and all-cause mortality was almost equal (p = 0.716). The 5-year survival rates were 93.9% and 92.2% in the off-pump and on-pump groups, respectively, and the 10-year survival rates were 86.3% and 82.1%, respectively. The repeat revascularization rate was significantly lower in the on-pump group (p = 0.0407). Both the on-pump and off-pump methods offer equally good long-term outcomes in terms of mortality and major adverse cardiac and cerebrovascular events. However, the need for repeat revascularization is a concern in the long term after off-pump surgery.
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Affiliation(s)
- Ryoi Okano
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
- Department of Cardiovascular Surgery, Ageo Central General Hospital, Saitama 362-8588, Japan.
| | - Yi-Jia Liou
- Department of Life Science, National Dong Hwa University, Hualien 97401, Taiwan.
| | - Hsi-Yu Yu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
| | - I-Hui Wu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
| | - Nai-Kuan Chou
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
| | - Yih-Sharng Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
| | - Nai-Hsin Chi
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
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Li X, Wang Z, Yang Y, Meng F, He Y, Yang P. Myocardial infarction following a blunt chest trauma: A case report. Medicine (Baltimore) 2019; 98:e14103. [PMID: 30681569 PMCID: PMC6358399 DOI: 10.1097/md.0000000000014103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/12/2018] [Accepted: 12/18/2018] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Blunt cardiac injury (BCI) is a common complication after blunt chest trauma, which can lead to mild arrhythmia, severe chamber or valvular rupture, or even death. Myocardial infarction following blunt chest trauma is a rare but fatal condition. PATIENT CONCERNS A 38-year-old, previously healthy, man was admitted to our hospital with a complaint of dyspnea. He had a history of being hit in the chest by a high-speed screw while working in a factory 3 months before he was admitted to the hospital. DIAGNOSIS After performing coronary angiography and echocardiography, he was finally diagnosed with myocardial infarction. INTERVENTIONS He received optimized medications, including diuretics, β-blockers, and cardiac stimulants. OUTCOMES At the 4-year follow-up, the patient was diagnosed as having chronic heart failure with a reduced ejection fraction. LESSONS Owing to the first doctor's lack of experience and knowledge with this case, the patient was misdiagnosed and treatment was delayed, which subsequently led to heart failure.BCI can lead to myocardial infarction if patients are misdiagnosed and treatment is delayed. Thus, surgeons and physicians should consider cardiac complications in patients with chest trauma to reduce the incidence of its misdiagnosis.
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Affiliation(s)
| | - Zhiyuan Wang
- Ultrasound Department, China-Japan Union Hospital of JiLin University, Changchun, Jilin, China
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Chhabra ST, Kaur T, Masson S, Soni RK, Bansal N, Takkar B, Tandon R, Goyal A, Singh B, Aslam N, Mohan B, Wander GS. Early onset ACS: An age based clinico-epidemiologic and angiographic comparison. Atherosclerosis 2018; 279:45-51. [DOI: 10.1016/j.atherosclerosis.2018.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/28/2018] [Accepted: 10/17/2018] [Indexed: 10/28/2022]
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21
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Andreenko EY, Yavelov IS, Loukianov ММ, Vernohaeva AN, Drapkina OM, Boytsov SA. Ischemic Heart Disease in Subjects of Young Age: Current State of the Problem. Features of Etiology, Clinical Manifestation and Prognosis. ACTA ACUST UNITED AC 2018; 58:24-34. [PMID: 30625075 DOI: 10.18087/cardio.2018.11.10195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 11/24/2018] [Indexed: 11/18/2022]
Abstract
In addition to conventional risk factors in young patients with ischemic heart disease (IHD) numerous other risk factors including genetics play an important role in its causation. Molecular genetic testing is recommended for the detection of monogenic diseases with a high risk of developing IHD, such as familial hypercholesterolemia. In majority ofyoung patients, the first manifestation of IHD is an acute coronary syndrome. Young patients with IHD more often have normal coronary arteries or single-vessel coronary disease, and in up to 20% of them cause of myocardial ischemia is not related to atherosclerosis. In general, young patients with IHD have better prognosis. However, there are sex differences in IHD outcomes the prognosis of patients with premature IHD and reason for this is still unclear.
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Affiliation(s)
- E Yu Andreenko
- National Medical Research Center for Preventive Medicine.
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[ST elevation myocardial infarction in young adults: Is there an interest for thrombophilia screening?]. Ann Cardiol Angeiol (Paris) 2018; 68:98-106. [PMID: 30342830 DOI: 10.1016/j.ancard.2018.09.012] [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] [Received: 09/14/2018] [Accepted: 09/21/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Coronary lesions characteristics as well as patient thrombogenicity can explain coronary events manifestation. In young patient, local conditions are usually less important and thrombogenicity could play a significant role. Assessing thrombophilia could be justified in young patients and may induce an adapted therapeutic management. PURPOSE We aimed to assess the prevalence of thrombophilia and therapeutic modification in young adults aged≤55 years admitted in our department for ST elevation myocardial infarction (STEMI). METHODS From January 2013 to January 2017, data on all patients aged≤55 years with STEMI admitted in emergency were retrospectively retrieved from our database. Thrombophilia investigation was made regarding clinical (with or without cardiovascular risk factors [CVRF]), biological and/or angiographic evaluation. RESULTS A total of 133 patients aged≤55 years with STEMI were included. Cardiac arrest occurred in 15 patients (11%). One or less CVRF were found in 47 patients (35%). Smoking was reported in 93 patients (70%) and drug addiction (cannabis, cocaine) in 19 patients (14%). A subset of 51 patients (38%) were screened for thrombophilia. Patients with thrombophilia assessment were younger, less active smokers and presented less CVRF than patients without investigation (P<0.001). Single vessel diseased was found in 88 patients (66%). No differences regarding coronary procedural characteristic were found between the two groups. The most frequently encountered aetiology, found in 122 patients (92%), was de novo intra-arterial thrombosis related to atherosclerosis. In patients with thrombophilia assessment (n=51), one or more abnormal biological results was found in 22 patients (43%) and a therapeutic adjustment was made in 6 patients (12%). CONCLUSION Thrombophilia screening in young STEMI adults showed an abnormality in 43% of cases. Antithrombotic treatment can be modified after its demonstration.
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Young adult cardiovascular diseases: a single center coronary computed tomography angiography study. Clin Imaging 2018; 52:343-349. [PMID: 30245389 DOI: 10.1016/j.clinimag.2018.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/27/2018] [Accepted: 09/18/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE AND BACKGROUND Cardiovascular disease (CVD) is one of the leading causes of death. However, the prevalence of CVD in young adults (<40 years of age) has not been well documented. We conducted this study to determine the proportion of CVD in both symptomatic and asymptomatic young adults. MATERIALS AND METHODS Coronary CT angiography images obtained from April 2015 to July 2017 in our institution was retrospectively reviewed. Young adults were separated into two groups according to whether they had experienced chest discomfort. The diagnosis was classified as normal, coronary artery disease (CAD), myocardial bridging (MB), congenital coronary anomaly, congenital cardiac anomaly, cardiomyopathy, and aortic anomaly. The proportion of different diagnoses in two groups and cardiovascular risk factors were analyzed. RESULTS Totally 107 patients (mean age, 35.6 ± 3.55 years) were grouped into 36 cases of symptomatic group and 71 patients of asymptomatic group. Cardiovascular anomalies were found in 61 cases (41%). No significant difference in the occurrence rates of CAD (14% vs 11%, p = 0.53), MB (31% vs 42%, p = 0.51), and congenital coronary anomaly (7% vs 3%, p = 0.26) between groups. Mild arterial stenosis was implied in most CAD cases. Hypertension was the only risk factor significantly correlated with CAD. CONCLUSIONS Although young adults are conventionally identified as low-risk, more than 60% of the cases in our cohort were proved to present cardiovascular anomalies, with no significant relation to cardiac symptoms. Early interventions should be conducted for aggressive CVD subtypes to prevent future acute events.
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The Prevalence, Clinical Spectrum and the Long Term Outcome of ST-segment Elevation Myocardial Infarction in Young - A Prospective Observational Study. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 20:387-391. [PMID: 30068493 DOI: 10.1016/j.carrev.2018.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Incidence of coronary artery disease at the younger age is rising. We studied the prevalence, clinical spectrum and long term outcome of ST-segment elevation myocardial infarction in young. MATERIAL AND METHODS This is a prospective observational study, performed at a tertiary care center from January 2015 to June 2016. Of the total 977 consecutive patients with ST segment elevation myocardial infarction (STEMI), 130 patients aged ≤45 years were included. All patients were followed-up for at least 1-year from the index admission. RESULTS The overall prevalence of STEMI among younger patients was 12.8%. There was male dominance (96.8%). Smoking (37.6%) was observed to be the most common risk factor for young STEMI, followed by diabetes mellitus (16.8%) and hypertension (16%). Younger patients with acute MI had preponderance to anterior wall (68.8%), single-vessel disease (50%) and left anterior descending artery being the culprit lesion (67.3%). Near normal/normal coronary arteries were observed in 12.9% of cases. The most commonly used management strategy was mechanical revascularisation (43.2%), followed by thrombolysis (28.8%) and medical management (28%). The overall mortality and combined MACCE rates at 1 year were 3.2% and 18.4% respectively. Outcome was better in patients who received mechanical revascularization/thrombolysis than those who received medical management only, with a lower MACCE rates (hazard ratio: 0.36; 95% CI: 0.16-0.8, p = 0.01. CONCLUSION The young MI patients are unique in having male dominance, better outcome, more of single-vessel disease with significant number of normal coronaries, better response to mechanical as well as pharmacological revascularization.
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Kim I, Kim MC, Sim DS, Hong YJ, Kim JH, Jeong MH, Cho JG, Park JC, Seung KB, Chang K, Ahn Y. Effect of the Metabolic Syndrome on Outcomes in Patients Aged <50 Years Versus >50 Years With Acute Myocardial Infarction. Am J Cardiol 2018; 122:192-198. [PMID: 29729896 DOI: 10.1016/j.amjcard.2018.03.366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/24/2018] [Accepted: 03/29/2018] [Indexed: 01/11/2023]
Abstract
The presence of metabolic syndrome (MS) is associated with an increased risk of cardiovascular disease morbidity and mortality. Moreover, data are lacking on the association of MS with clinical outcomes in young adults with acute myocardial infarction (AMI). This study was a retrospective analysis of 2,082 patients with AMI who underwent percutaneous coronary intervention. The term young was defined as age <50 years. The prevalence of patients aged <50 years was 18.4%. Among those patients, 43.4% had MS. The highest incidence of long-term major adverse cardiac and cerebral events was in old patients without MS (30.7% in young patients with MS, 22.2% in young patients without MS, 38.4% in old patients with MS, and 40.4% in old patients without MS, p <0.001). However, recurrent AMI (re-AMI) was the highest in young AMI patients with MS (4.8%, 1.4%, 2.1%, and 1.5%, p = 0.035, respectively). In Kaplan-Meier curve, young AMI patients with MS tend to have highest incidence of re-AMI (p = 0.050). The presence of MS in young AMI patients was an independent predictor of 6-year major adverse cardiac and cerebral events (hazard ratio 3.320, 95% confidence interval 1.073 to 10.283, p = 0.038) and re-AMI (hazard ratio 7.782, 95% confidence interval 1.290 to 45.298, p = 0.022). In conclusion, almost half of young patients with AMI had MS. The young AMI patients with MS had the highest incidence of re-AMI compared with the other groups. Aggressive pharmacological intervention and lifestyle modification are needed for the management of AMI in young patients with MS.
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Gao M, Zhao W, Zhang Z, Qin L, Zhang W, Zheng Y. Clinical Characteristics and Outcomes in Young Patients With ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention. Am J Med Sci 2018; 355:544-552. [PMID: 29891037 DOI: 10.1016/j.amjms.2018.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND There are few published studies of ST-segment elevation myocardial infarction (STEMI) in younger individuals. The differences between these "younger" and "older" individuals may not be fully appreciated by clinicians. The aim of this study was to determine the reasons for the earlier presentation and help to identify strategies for prevention of recurrent myocardial infarction (MI) in younger patients. METHODS The study population was a cohort of 2,419 consecutive STEMI patients who were treated with primary percutaneous coronary intervention. The median follow-up time of this retrospective study was 2.2 years. RESULTS The all-cause mortality rates in patients ≤45 years of age at 30 days, 1 and 2 years were 1.7%, 2.0% and 2.2%, respectively. These rates were lower compared with their older matched counterparts whose all-cause mortality rates were 3.3%, 4.2% and 5.5%, respectively (P = 0.010). The incidence of recurrent MI was 4.0% for all age groups combined, 5.4% for younger patients and 3.8% for older patients. The number of stents showed association with recurrent MI in older patients with a first infarction, whereas only composition factor 1 with significantly higher non-high-density lipoprotein and low-density lipoprotein values was significantly associated with recurrent MI in the younger patients. CONCLUSIONS STEMI patients ≤45 years of age more often had lower rates of all-cause mortality, but the risk of recurrent MI was similar to that of older patients. Regardless of triglyceride level, neither non-high-density lipoprotein nor low-density lipoprotein were independent predictors for recurrent MI during the long-term follow-up in younger patients.
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Affiliation(s)
- Ming Gao
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China
| | - Waiou Zhao
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China
| | - Zhiguo Zhang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China
| | - Ling Qin
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China
| | - Weihua Zhang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China
| | - Yang Zheng
- Department of Cardiology, The First Hospital of Jilin University, Changchun, China.
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Caimi G, Hopps E, Montana M, Andolina G, Urso C, Canino B, Lo Presti R. Analysis of the Blood Viscosity Behavior in the Sicilian Study on Juvenile Myocardial Infarction. Clin Appl Thromb Hemost 2018; 24:1276-1281. [PMID: 29792062 PMCID: PMC6714779 DOI: 10.1177/1076029618775511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Considering the role of hemorheology in coronary circulation, we studied blood viscosity in patients with juvenile myocardial infarction. We examined whole blood viscosity at high shear rate using the cone-on-plate viscosimeter Wells-Brookfield ½ LVT and at low shear rate employing a viscometer Contraves LS30 in 120 patients (aged <46 years) with myocardial infarction, at the initial stage and subsequently 3 and 12 months after. At the initial stage, patients had an increased whole blood viscosity in comparison to normal controls. This hemorheological profile was not influenced by the cardiovascular risk factors, nor by the extent of coronary lesions, even if some differences were evident between patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). The blood viscosity pattern at the initial stage did not influence recurring ischemic events or the onset of heart failure during an 18 months’ follow-up. The neutrophil to lymphocyte ratio did not affect the blood viscosity pattern. We reevaluated 83 patients 3 months after and 70 patients 12 months after the acute coronary syndrome, and we found that the hemorheological parameters were still altered in comparison to normal controls at both times. We observed an impairment of the hemorheological pattern in young patients with myocardial infarction, partially influenced by the infarction type (STEMI and NSTEMI) and persisting in the long term.
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Affiliation(s)
- Gregorio Caimi
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Eugenia Hopps
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Maria Montana
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Giuseppe Andolina
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Caterina Urso
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Baldassare Canino
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - Rosalia Lo Presti
- 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
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Abstract
We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. AMI is rarely seen in young women, but Takayasu's arteritis is one major cause. If a young woman complaining of typical chest pain as acute coronary syndrome is encountered, systemic diseases must be considered.
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Affiliation(s)
- Yusuke Ishiyama
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan
| | - Kazuo Eguchi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan
| | - Katsuaki Yokota
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan
| | - Tomokazu Ikemoto
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan
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Clinical Characteristics and Burden of Risk Factors Among Patients With Early Onset Acute Coronary Syndromes: The ANZACS-QI New Zealand National Cohort (ANZACS-QI 17). Heart Lung Circ 2018; 27:568-575. [DOI: 10.1016/j.hlc.2017.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 03/02/2017] [Accepted: 04/23/2017] [Indexed: 01/09/2023]
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30
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Barroso M, Goday A, Ramos R, Marín-Ibañez A, Guembe MJ, Rigo F, Tormo-Díaz MJ, Moreno-Iribas C, Cabré JJ, Segura A, Baena-Díez JM, de la Cámara AG, Lapetra J, Quesada M, Medrano MJ, Berjón J, Frontera G, Gavrila D, Barricarte A, Basora J, García JM, García-Lareo M, Lora-Pablos D, Mayoral E, Grau M, Marrugat J. Interaction between cardiovascular risk factors and body mass index and 10-year incidence of cardiovascular disease, cancer death, and overall mortality. Prev Med 2018; 107:81-89. [PMID: 29155226 DOI: 10.1016/j.ypmed.2017.11.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/03/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19-4.61) and 5.65 (1.54-20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53-10.37) and 11.61 (1.93-69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03-2.54) and 1.34 (1.01-1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.
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Affiliation(s)
- Maria Barroso
- REGICOR Study Group - Cardiovascular Epidemiology and Genetics, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; Primary Care Center La Marina and Primary Health Care Research Institute Jordi Gol, Catalan Institute of Health, Barcelona, Spain
| | - Albert Goday
- Parc de Salut Mar, Barcelona, Spain; Consortium for Biomedical Research in Obesity and Nutrition (CIBEROBN), Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Spain
| | - Rafel Ramos
- Family Medicine Research Unit and Primary Health Care Research Unit Institute Jordi Gol, Catalan Institute of Health, Girona, Spain; University of Girona, Spain
| | | | - Maria Jesús Guembe
- Vascular Risk in Navarra Research Group (RIVANA), Health Department, Navarra Government, Pamplona, Spain; Knowledge Planning, Evaluation and Management, Health Department, Navarra Government, Pamplona, Spain
| | - Fernando Rigo
- Cardiovascular Group of Balearic Islands (REDIAP-IBSALUT), Palma de Mallorca, Spain
| | - Maria José Tormo-Díaz
- Murcian Health Department, Murcia, Spain; University of Murcia, Spain; Murcian Institute of Biomedical Research (IMIMB), Murcia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Conchi Moreno-Iribas
- Navarre Public Health Institute, Pamplona, Spain; Research Network for Health Services in Chronic Disease (REDISSEC), Pamplona, Spain; Navarra Hospital, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Joan Josep Cabré
- Primary Care Center Sant Pere Centre and Primary Health Care Research Unit Institute Jordi Gol, Catalan Institute of Health, Reus-Tarragona, Spain
| | - Antonio Segura
- Health Science Institute, Department of Health and Social Affairs, Castile - La Mancha Government, Talavera de la Reina, Spain
| | - Jose Miguel Baena-Díez
- REGICOR Study Group - Cardiovascular Epidemiology and Genetics, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; Primary Care Center La Marina and Primary Health Care Research Institute Jordi Gol, Catalan Institute of Health, Barcelona, Spain
| | - Agustín Gómez de la Cámara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Clinical Research Department, Hospital 12 Octubre Research Institute, Madrid, Spain
| | - José Lapetra
- Consortium for Biomedical Research in Obesity and Nutrition (CIBEROBN), Spain; Department of Family Medicine, Research Unit, Primary Care Division of Seville, Spain
| | - Miquel Quesada
- Family Medicine Research Unit and Primary Health Care Research Unit Institute Jordi Gol, Catalan Institute of Health, Girona, Spain
| | | | - Jesús Berjón
- Vascular Risk in Navarra Research Group (RIVANA), Health Department, Navarra Government, Pamplona, Spain; Navarra Hospital, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Guillem Frontera
- Cardiovascular Group of Balearic Islands (REDIAP-IBSALUT), Palma de Mallorca, Spain
| | - Diana Gavrila
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Health and Consumers Department, Murcia Government, Murcia, Spain
| | - Aurelio Barricarte
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Navarre Public Health Institute, Pamplona, Spain; Research Network for Health Services in Chronic Disease (REDISSEC), Pamplona, Spain
| | - Josep Basora
- Primary Health Care Research Unit Institute Jordi Gol, Catalan Institute of Health, Reus-Tarragona, Spain
| | - José María García
- Health Science Institute, Department of Health and Social Affairs, Castile - La Mancha Government, Talavera de la Reina, Spain
| | - Manel García-Lareo
- Primary Care Center La Marina and Primary Health Care Research Institute Jordi Gol, Catalan Institute of Health, Barcelona, Spain
| | - David Lora-Pablos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain; Clinical Research Department, Hospital 12 Octubre Research Institute, Madrid, Spain
| | - Eduardo Mayoral
- Consortium for Biomedical Research in Obesity and Nutrition (CIBEROBN), Spain; Diabetes Strategy, Andalusia Health Service, Sevilla, Spain
| | - María Grau
- REGICOR Study Group - Cardiovascular Epidemiology and Genetics, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; CIBERCV CIBER de Enfermedades Cardiovasculares, Spain; University of Barcelona, Spain.
| | - Jaume Marrugat
- REGICOR Study Group - Cardiovascular Epidemiology and Genetics, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; CIBERCV CIBER de Enfermedades Cardiovasculares, Spain.
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31
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Prevalence of Takayasu arteritis in young women with acute ischemic heart disease. Int J Cardiol 2018; 252:21-23. [DOI: 10.1016/j.ijcard.2017.10.067] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/17/2017] [Accepted: 10/17/2017] [Indexed: 11/19/2022]
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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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Rallidis LS, Pavlakis G, Foscolou A, Kotakos C, Katsimardos A, Drosatos A, Zolindaki M, Panagiotakos DB. High levels of lipoprotein (a) and premature acute coronary syndrome. Atherosclerosis 2017; 269:29-34. [PMID: 29258004 DOI: 10.1016/j.atherosclerosis.2017.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/20/2017] [Accepted: 12/06/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS High levels of lipoprotein(a) [Lp(a)] are associated with increased risk of acute coronary syndrome (ACS). We explored whether Lp(a) exhibits a stronger association with premature ACS. METHODS A case-control study was conducted; 1457 patients with a history of ACS (54.8 ± 13 years, 86% males) and 2090 age-sex matched adults free of cardiovascular disease were enrolled. Bio-clinical characteristics [risk factors, low-density lipoprotein-cholesterol, Lp(a)] were derived through standard procedures. RESULTS A 10 mg/dL increase in Lp(a) was associated with 4% (95% CI, 1.01 to 1.02) higher likelihood of having ACS in younger (<45 years) and 2% (95% CI, 1.01 to 1.02) higher likelihood in middle-aged (45-60 years) individuals. Adjusting for common risk factors, elevated Lp(a), i.e. >50 mg/dL, was still associated with increased likelihood of ACS in younger adults (<45 years) (OR = 2.88, 95% CI, 1.7 to 4.6) and in middle aged ones (45 and 60 years) (OR = 2.06, 95% CI, 1.4 to 3.2), but not in older participants (>60 years) (OR = 1.31, 95% CI, 0.8 to 2.4). CONCLUSIONS Lp(a) seems to be an independent risk factor for ACS in individuals <45 years, and high Lp(a) levels increase by ∼3folds the risk for ACS. The association is preserved but is less in middle-aged individuals (45-60 years) and is abolished >60 years.
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Affiliation(s)
- Loukianos S Rallidis
- Second Department of Cardiology, University General Hospital Attikon, Athens, Greece.
| | | | - Alexandra Foscolou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | - Andreas Katsimardos
- Second Department of Cardiology, University General Hospital Attikon, Athens, Greece
| | - Alexandros Drosatos
- Second Department of Cardiology, University General Hospital Attikon, Athens, Greece
| | - Maria Zolindaki
- Biochemistry Laboratory, General Hospital of Nikea, Piraeus, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Australia; School of Allied Health, College of Science, Health and Engineering, LA TROBE University, Australia
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Saraiva J, Antunes PE, Antunes MJ. Coronary artery bypass surgery in young adults: excellent perioperative results and long-term survival. Interact Cardiovasc Thorac Surg 2017; 24:691-695. [PMID: 28453797 DOI: 10.1093/icvts/ivw407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/03/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To analyse perioperative results, long-term survival and freedom from complications after coronary artery bypass grafting (CABG) in young adults. METHODS A total of 163 patients, 40 years old or younger, had isolated CABG from January 1989 to December 2010. Pre- and perioperative demographic and clinical data were retrieved from a prospectively organised database. Follow-up data were obtained by letter or telephone interviews. The mean age of the patients was 37.6 ± 2.9 years and 146 were men (90%). Fifty-three patients (32.5%) had angina class III/IV; 106 (65.0%), previous myocardial infarction; and 23 (14.1%), impaired left ventricular function (ejection fraction <40%). Indication for surgery was 3-vessel disease in 101 cases (62.0%), 2-vessel disease in 30 (18.4%) and single-vessel disease in 32 (19.6%). The left main stem was affected in 16 patients (9.8%). The mean EuroSCORE II was 0.92 ± 0.71. A total of 417 grafts were constructed (mean 2.6 grafts/patient), 247 of which (59.2%) were arterial. RESULTS There were no in-hospital deaths. The mean hospital stay was 7.1 ± 4.0 days. Four patients (2.5%) were lost to follow-up, which extended from 3 to 25 years (mean 15.1 ± 5.5 years). There were 22 late deaths, 72.7% of cardiac or unknown origin. The 5-, 10- and 20-year survival rates were 98.7 ± 10.9, 95.2 ± 1.8 and 79.4 ± 4.4%, respectively. Twenty-six patients (18.1%) had non-fatal cardiac adverse complications (myocardial infarct, percutaneous re-revascularization or class III/IV angina), for 5-, 10- and 20-year freedom from complications of 97.9 ± 1.2, 91.9 ± 2.5 and 65.7 ± 7.1%, respectively. Twenty-two patients (17.5%) needed re-revascularization, for 5-, 10- and 20-year freedom from re-revascularization of 97.6 ± 1.4, 91.9 ± 2.6 and 69.5 ± 6.7%, respectively. CONCLUSIONS Despite the aggressive nature of coronary artery disease in young patients, perioperative death and morbidity rates are low, with good long-term survival and low rates of re-revascularization.
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Affiliation(s)
- Joana Saraiva
- Centre of Cardiothoracic Surgery, Coimbra, University Hospital and Faculty of Medicine, Coimbra, Portugal
| | - Pedro E Antunes
- Centre of Cardiothoracic Surgery, Coimbra, University Hospital and Faculty of Medicine, Coimbra, Portugal
| | - Manuel J Antunes
- Centre of Cardiothoracic Surgery, Coimbra, University Hospital and Faculty of Medicine, Coimbra, Portugal
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Barbero U, Scacciatella P, Iannaccone M, D'Ascenzo F, Niccoli G, Colombo F, Ugo F, Colangelo S, Mancone M, Calcagno S, Sardella G, Amabile N, Motreff P, Toutouzas K, Garbo R, Tamburino C, Montefusco A, Omedè P, Moretti C, D'amico M, Souteyrand G, Gaita F, Templin C. Culprit plaque characteristics in younger versus older patients with acute coronary syndromes: An optical coherence tomography study from the FORMIDABLE registry. Catheter Cardiovasc Interv 2017; 92:E1-E8. [DOI: 10.1002/ccd.27172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/07/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Umberto Barbero
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Paolo Scacciatella
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Mario Iannaccone
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
- Department of Cardiology; S.G. Bosco Hospital; Turin Italy
| | - Fabrizio D'Ascenzo
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Giampaolo Niccoli
- Department of Cardiology, Catholic University of the Sacred Heart; Rome Italy
| | | | - Fabrizio Ugo
- Department of Cardiology; S.G. Bosco Hospital; Turin Italy
| | | | - Massimo Mancone
- Department of Cardiovascular; Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome; Italy
| | - Simone Calcagno
- Department of Cardiovascular; Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome; Italy
| | - Gennaro Sardella
- Department of Cardiovascular; Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome; Italy
| | - Nicolas Amabile
- Cardiology Department; CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University; Clermont-Ferrand France
| | - Pascal Motreff
- Cardiology Department; CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University; Clermont-Ferrand France
| | - Konstantinos Toutouzas
- First Department of Cardiology; Hippokration Hospital, Athens Medical School; Athens Greece
| | - Roberto Garbo
- Department of Cardiology; S.G. Bosco Hospital; Turin Italy
| | - Corrado Tamburino
- Cardio-thoracic-vascular Department; Ferrarotto Hospital, University of Catania; Italy
| | - Antonio Montefusco
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Pierluigi Omedè
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Claudio Moretti
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Maurizio D'amico
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Geraud Souteyrand
- Cardiology Department; CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University; Clermont-Ferrand France
| | - Fiorenzo Gaita
- Department of Cardiology; University of Turin, Città della Scienza e della Salute Hospital; Turin Italy
| | - Christian Templin
- Department of Cardiology; Zurich University Hospital; Zurich Switzerland
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Prothrombotic genetic risk factors in patients with very early ST-segment elevation myocardial infarction. J Thromb Thrombolysis 2017. [DOI: 10.1007/s11239-017-1520-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Association between fibrinogen level and the severity of coronary stenosis in 418 male patients with myocardial infarction younger than 35 years old. Oncotarget 2017; 8:81361-81368. [PMID: 29113395 PMCID: PMC5655290 DOI: 10.18632/oncotarget.18578] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 05/21/2017] [Indexed: 12/21/2022] Open
Abstract
Fibrinogen (Fib) is a useful marker for predicting the severity of coronary artery disease (CAD) in adult population. However, whether Fib can be a predictor for the presence and severity of CAD in very young MI patients (≤35 years old) remains to be determined. A total of 418 males from 61,863 patients with MI who were under 35 years old were sequentially recruited in our study. The patients were divided into two main groups and three subgroups according to coronary angiograph and Gensini score (GS) system: no coronary artery stenosis (group A), the results of the coronary artery stenosis (group B); low GS, intermediate GS and high GS. Data indicated that Fib, body mass index, current smoking, white blood cell count (WBCC) and GS were significantly higher in group B than those in group A (all P < 0.01). Moreover, there were significant differences in Fib, mean age, diabetes mellitus, family history of CAD, WBCC, left ventricular ejection fraction, and GS between high GS and low GS subgroups (all P < 0.01). A positive correlation between Fib levels and GS was found (r = 0.242, p < 0.001). Receiver operating characteristics curve analysis demonstrated that the best cut-off level of Fib predicting the severity of coronary stenosis was 3.475g/L (sensitivity 64%; specificity 70%) and the area under the curve was 0.656. Fib was also independently associated with high GS (OR=2.173, 95%CI 1.011–4.670, P = 0.047) after adjusting for potential confounders. In conclusion, Fib is significantly related to the presence and severity of coronary stenosis in male patients with MI under 35 years old.
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Matsis K, Holley A, Al-Sinan A, Matsis P, Larsen PD, Harding SA. Differing Clinical Characteristics Between Young and Older Patients Presenting with Myocardial Infarction. Heart Lung Circ 2017; 26:566-571. [DOI: 10.1016/j.hlc.2016.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/03/2016] [Accepted: 09/02/2016] [Indexed: 11/26/2022]
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Merritt CJ, de Zoysa N, Hutton JM. A qualitative study of younger men's experience of heart attack (myocardial infarction). Br J Health Psychol 2017; 22:589-608. [PMID: 28544174 DOI: 10.1111/bjhp.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 04/14/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The effects of heart attack, or myocardial infarction (MI), across psychosocial domains may be particularly acute in younger adults, for whom serious health events are non-normative. MI morbidity is declining in Western countries, but in England MI numbers have plateaued for the under-45 cohort, where approximately 90% of patients are male. Qualitative research on younger adults' experience of MI is limited, and no study has sampled exclusively under-45s. This study aimed to understand how a sample of men under 45 adjusted to and made sense of MI. DESIGN Qualitative research design based on semi-structured in-depth interviews. METHODS Ten men aged under 45 who had experienced MI in the past 3-6 months were purposively recruited and interviewed. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS Seven superordinate themes were identified. This article focuses in depth on the three most original themes: (1) 'I'm less of a man', which described experiences of losing 'maleness' (strength, independence, ability to provide) post-MI; (2) 'Shortened horizons', which covered participants' sense of foreshortened future and consequent reprioritization; and (3) 'Life loses its colour', describing the loss of pleasure from lifestyle-related changes. CONCLUSION Themes broadly overlapped with the qualitative literature on younger adult MI. However, some themes (e.g., loss of 'maleness' post-MI, and ambivalence towards MI risk factors) appeared unique to this study. Themes were also discussed in relation to risk factors for anxiety and depression and how this might inform clinical care for a younger, male population. Statement of contribution What is already known on this subject? Myocardial infarction (MI) morbidity is not declining in England for under-45s. Adjustment to MI is particularly challenging for younger adults, perhaps because it is non-normative. However, little is known about the experience of MI in younger adults. What does this study add? This is the first qualitative study to sample MI patients exclusively under 45, thereby mapping to epidemiological trends. Further support is provided for some themes identified in the existing young adult MI literature. New themes are identified here which can provide insights relevant to clinical care in this population.
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Affiliation(s)
| | - Nicole de Zoysa
- South London and Maudsley NHS Foundation Trust and King's College Hospital NHS Foundation Trust, London, UK
| | - Jane M Hutton
- South London and Maudsley NHS Foundation Trust and King's College Hospital NHS Foundation Trust, London, UK
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40
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Tini G, Proietti G, Casenghi M, Colopi M, Bontempi K, Autore C, Volpe M, Musumeci B. Long-Term Outcome of Acute Coronary Syndromes in Young Patients. High Blood Press Cardiovasc Prev 2017; 24:77-84. [DOI: 10.1007/s40292-017-0183-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/19/2017] [Indexed: 10/20/2022] Open
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Male E, Morton T, Farber A, Michel J. St-Elevation Acute Myocardial Infarction Due to Arterial Thrombosis in a 29-Year-Old Woman with Normal Coronary Arteries. Proc (Bayl Univ Med Cent) 2017; 30:59-61. [DOI: 10.1080/08998280.2017.11929529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Platelets miRNA as a Prediction Marker of Thrombotic Episodes. DISEASE MARKERS 2016; 2016:2872507. [PMID: 28042196 PMCID: PMC5155104 DOI: 10.1155/2016/2872507] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/04/2016] [Indexed: 11/18/2022]
Abstract
The blood platelets are crucial for the coagulation physiology to maintain haemostatic balance and are involved in various pathologies such as atherosclerosis and thrombosis. The studies of recent years have shown that anucleated platelets are able to succeed protein synthesis. Additionally, mRNA translation in blood platelets is regulated by miRNA molecules. Recent works postulate the possibility of using miRNAs as biomarkers of atherosclerosis and ischemic episodes. This review article describes clinical studies that presented blood platelets miRNAs expression profile changes in different thrombotic states, which suggest use of these molecules as predictive biomarkers.
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Abstract
INTRODUCTION Atherosclerotic coronary artery disease is an important cause of sudden and unexpected deaths in the young people. It is assumed that thrombosis and plaque hemorrhage are commonly associated with sudden deaths from coronary atherosclerosis in the young. In this study, we compared the histological patterns of atherosclerosis in young and old populations to see whether an association exists between the histological pattern of atherosclerosis in the young and thrombosis or plaque hemorrhage. METHODS AND RESULTS All autopsy cases of coronary atherosclerosis in young people (aged younger than 40 years) in comparison with an equal number of randomly selected older people (older than 65 years) over a period of 4 and a half years in the Provincial Forensic Pathology Unit of the Ontario Forensic Pathology Service in Toronto, Canada, were reviewed to characterize the gross and histologic appearance. There were 28 cases of atherosclerosis in young people ("the young"). Twenty-three (82%) of the young had eccentric atherosclerosis compared with 11 (39%) of the old. An inflammatory response was seen in all 28 (100%) of the young in comparison with 17 (61%) of the old. Thirteen (47%) of the young compared with 3 (11%) of the old had thrombosis, whereas 9 (32%) of the young and 17 (61%) of the old had plaque hemorrhage. Pultaceous debris was the principal component in 11 atherosclerotic plaques (39%) in the young, followed by foam cells in 7 (25%). In the older group, pultaceous debris was the principal component in 18 (64%) followed by dense fibrous tissue in 5 (18%). CONCLUSIONS The morphology in coronary atherosclerosis of the young is significantly different from the old. Coronary atherosclerosis in the young commonly shows an eccentric distribution with associated inflammation. Thrombosis is commoner among the young, whereas plaque hemorrhage is commoner among the old.
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The fundamental importance of smoking cessation in those with premature ST-segment elevation acute myocardial infarction. Curr Opin Cardiol 2016; 31:531-6. [DOI: 10.1097/hco.0000000000000320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Celik T, Balta S, Ozturk C, Kaya MG, Aparci M, Yildirim OA, Demir M, Unlu M, Demirkol S, Kilic S, Iyisoy A. Predictors of No-Reflow Phenomenon in Young Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology 2016; 67:683-689. [DOI: 10.1177/0003319715605977] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
No-reflow is of prognostic value in ST-segment elevation myocardial infarction (STEMI) but has not been extensively investigated in young patients. Young patients with STEMI admitted within 12 hours from symptom onset and treated by primary percutaneous coronary intervention (pPCI) were recruited. Patients were classified into 2 groups based on postintervention thrombolysis in myocardial infarction (TIMI) flow grade; no-reflow: TIMI flow grade 0, 1 or 2 (group 1; n = 27; 21 men, mean age: 42 ± 4 years); and angiographic success: TIMI flow grade 3 (group 2; n = 118; 110 men, mean age: 43 ± 4 years). Adjusted odds ratios were 13.79 for female gender ( P < .001; confidence interval [CI] = 1.88-101.26), 2.09 for pain to balloon time ( P < .017; CI = 1.14-3.812), 12.29 for high TIMI thrombus grade ( P = .012; CI = 1.74-86.94), 0.04 for tirofiban use ( P < .001; CI = 0.01-0.22), 5.19 for mean platelet volume (MPV; P < .001; CI = 2.44-11.01), and 1.008 for platelet–lymphocyte ratio (PLR; P = .034; CI = 1.001-1.016). In conclusion, female gender, pain to balloon time, high TIMI thrombus grade, tirofiban, MPV, and PLR were independent predictors of no-reflow in young patients with STEMI after pPCI.
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Affiliation(s)
- Turgay Celik
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Cengiz Ozturk
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Aparci
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Osman A. Yildirim
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Mustafa Demir
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Murat Unlu
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Selim Kilic
- Department of Epidemiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Atila Iyisoy
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
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Caimi G, Lo Presti R, Andolina G, Hopps E. Short-Term Prognosis of Juvenile Myocardial Infarction. Angiology 2016; 67:799-801. [PMID: 26764365 DOI: 10.1177/0003319715626065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Gregorio Caimi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
| | - R Lo Presti
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
| | - G Andolina
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
| | - E Hopps
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
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Caimi G, Lo Presti R, Canino B, Ferrera E, Hopps E. Behaviour of the neutrophil to lymphocyte ratio in young subjects with acute myocardial infarction. Clin Hemorheol Microcirc 2016; 62:239-47. [DOI: 10.3233/ch-151968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Coronary heart disease (CHD) sustains a significant negative impact on hospital admissions and deaths worldwide. The prevalence of CHD in young adults is difficult to establish accurately, as these asymptomatic patients typically do not undergo diagnostic studies. In this article, the authors will focus on young adults with CHD emphasizing common and uncommon risk factors, current management and review of previous studies.
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Gränsbo K, Almgren P, Nilsson PM, Hedblad B, Engström G, Melander O. Risk factor exposure in individuals free from cardiovascular disease differs according to age at first myocardial infarction. Eur Heart J 2016; 37:1977-81. [DOI: 10.1093/eurheartj/ehw026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 01/20/2016] [Indexed: 02/01/2023] Open
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Celik T, Balta S, Ozturk C, Iyisoy A. Survival of the young patients with acute ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention: Does gender matters? Int J Cardiol 2016; 210:54-5. [PMID: 26925922 DOI: 10.1016/j.ijcard.2016.02.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/14/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Turgay Celik
- Gulhane Military Medical Academy, School of Medicine, Department of Cardiology, Etlik, Ankara, Turkey.
| | - Sevket Balta
- Gulhane Military Medical Academy, School of Medicine, Department of Cardiology, Etlik, Ankara, Turkey
| | - Cengiz Ozturk
- Gulhane Military Medical Academy, School of Medicine, Department of Cardiology, Etlik, Ankara, Turkey
| | - Atila Iyisoy
- Gulhane Military Medical Academy, School of Medicine, Department of Cardiology, Etlik, Ankara, Turkey
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