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Chachar TS, Noor HA, AlAnsari NF, Masood A, Alraee A, Amin H, Yousif N. Clinical Characteristics and Outcomes of ST-Elevation Myocardial Infarction in Young Patients: A Single-Center Experience. Cureus 2024; 16:e53688. [PMID: 38455833 PMCID: PMC10918498 DOI: 10.7759/cureus.53688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMI and had primary percutaneous coronary intervention (pPCI). Results In this study, 510 patients with STEMI receiving pPCI were included, of whom 95 (18%) were younger than 45 years. The young age group had more smokers (57.9% vs. 40.5%, p = 0.003), newly diagnosed dyslipidemia (41.1% vs. 25.5%, p = 0.004), and a positive family history of early coronary artery disease (CAD) (14.7% vs. 4.3%, p = <0.001). Traditional cardiovascular risk factors, such as diabetes mellitus, systemic hypertension, and dyslipidemia, were significantly less common in young patients. Major adverse cardiovascular and cerebrovascular events (MACCE) were also significantly less common in young patients at the one-year follow-up (2.1 vs. 8.4%, p = 0.05). Conclusion Young patients with STEMI are more often smokers with undiagnosed dyslipidemia and have a family history of CAD. MACCE at one year is significantly lower as compared to older patients, but it is not negligible. Public health efforts are needed to reduce the prevalence of modifiable risk factors among the susceptible population.
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Affiliation(s)
- Tarique S Chachar
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Husam A Noor
- Cardiology, Bahrain Defence Force Hospital, Awali, BHR
| | - Nouf F AlAnsari
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Abdulrahman Masood
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Abdulrahman Alraee
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Haitham Amin
- Interventional Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
| | - Nooraldaem Yousif
- Interventional Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
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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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Dessai BS, Kumar S. Epidemiological profile among young patients (≤45 years) suffering from acute myocardial infarction in a tertiary care center in Goa. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_413_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Algowhary M. Association between age and infection in patients with acute ST-elevation myocardial infarction. Egypt Heart J 2021; 73:12. [PMID: 33515355 PMCID: PMC7847417 DOI: 10.1186/s43044-021-00137-w] [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: 10/10/2020] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background ST-elevation myocardial infarction (STEMI) in young patients has a unique risk profile. We aimed to detect bacteria in aspirate of infarct artery in young versus old patients. Results Aspirates of consecutive 140 patients who underwent a primary coronary intervention were taken for bacteriological, microscopical, and immunohistochemical (for bacterial pneumolysin) examinations. Their results were calculated in young (≤ 50 years) versus old (> 50 years) patients. Median age (interquartile range) was 45 (38–48) years in young (60 patients) and 59 (55–65) years in old (80 patients) patients, p < 0.0001. Both groups had similar baseline data except age, males, diabetes, hyperlipidemia, family history, lesion length, and ectatic vessel. Different bacteria were cultured in 11.3% of all patients involving 22.6% of young and 2.8% of old patients [hazard ratio 8.03 (95% CI 1.83–51.49), p = 0.002]. By multivariate analyses, age groups and leukocytic count were independent predictors of infection (bacteria and pneumolysin), p = 0.027 and p < 0.0001, respectively. Optimal cutoff value of leukocytic count was 12,250 cells/μl [ROC curve sensitivity 85.7%, specificity 86.4%, and AUC 0.97 (95% CI 0.95–1.0), p < 0.001]. Infection was an independent predictor of STEMI in young versus old patients, p < 0.001. Nevertheless, in-hospital events occurred insignificantly different and neither age groups nor infection was predictor of in-hospital events. Conclusions Young patients had significantly higher percentage of bacteria in their infarcted artery than old patients. High leukocytic count in patients below 50 predicts infection that causes acute myocardial infarction. Antibacterial trials directed toward this group are required for secondary prevention.
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Affiliation(s)
- Magdy Algowhary
- Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut University, Asyut, 71515, Egypt.
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Mohamed Bakrim N, Mohd Shah ANS, Talib NA, Ab Rahman J, Abdullah A. Identification of Haptoglobin as a Potential Biomarker in Young Adults with Acute Myocardial Infarction by Proteomic Analysis. Malays J Med Sci 2020; 27:64-76. [PMID: 32788843 PMCID: PMC7409576 DOI: 10.21315/mjms2020.27.2.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/22/2020] [Indexed: 01/01/2023] Open
Abstract
Background Acute myocardial infarction (AMI) molecular research in young adults is still limited. The aim of this study is to identify AMI proteomic biomarker(s) in young adults. Methods This study comprised of two phases namely discovery and verification. In the discovery phase, proteins in the pooled plasma samples from young male adults between 18 and 45 years (10 AMI patients and 10 controls) were separated using two-dimensional electrophoresis. The protein spots that were expressed differently in the AMI patients were identified via matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. The plasma concentrations of these proteins were quantified using enzyme-linked immunosorbent assay during the verification phase (40 AMI patients and 80 controls). Results Haptoglobin (Hp), apolipoprotein AI (Apo AI) and apolipoprotein AIV (Apo AIV) were up-regulated in the discovery phase. In the verification phase, the plasma concentration of Hp was significantly higher in AMI patients than the controls (P < 0.001). Logistic regression showed an association between Hp and AMI in young adults (odds ratio [OR] = 1.016, 95% CI: 1.002–1.030, P = 0.025) independent of other AMI risk factors. Hp was significantly correlated with high sensitivity C-reactive protein (hs-CRP) (r = 0.424, P < 0.001). Conclusion In young adults with AMI, plasma Hp concentrations were elevated and it is independently associated with AMI. A positive correlation with hs-CRP suggests Hp could be a potential biomarker of AMI in young adults.
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Affiliation(s)
- Norbaiyah Mohamed Bakrim
- Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Aida Nur Sharini Mohd Shah
- Department of Internal Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Norlelawati A Talib
- Department of Pathology and Laboratory Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Jamalludin Ab Rahman
- Department of Community Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Aszrin Abdullah
- Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
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Hoo FK, Foo YL, Lim SMS, Ching SM, Boo YL. Acute coronary syndrome in young adults from a Malaysian tertiary care centre. Pak J Med Sci 2016; 32:841-5. [PMID: 27648025 PMCID: PMC5017088 DOI: 10.12669/pjms.324.9689] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective: Acute coronary syndrome (ACS) is one of the leading cause of morbidity and mortality worldwide. It is relatively uncommon in young adults as compared to the older population. Our objective was to assess the prevalence, demographic distribution, and risk factors for acute coronary syndrome (ACS) in patients less than 45 years of age admitted to a Malaysian tertiary care centre. Methods: This is a cross-sectional, retrospective, and single centre study with random sampling of the patients admitted for ACS to hospital from January 2005 to December 2013. Data were collected and analyzed. Patients less than 45 years of age were compared with patients more than 45 years of age. Result: A total of 628 patients were included in the study and with the prevalence of young ACS was 6.1% and mean age of 39±6 years. All the young ACS patients were diagnosed with unstable angina and non-ST elevation myocardial infarction (NSTEMI). Tobacco smoking and family history of coronary artery disease (CAD) were more frequent in young ACS. 59.5% of the young ACS patients were smokers, while 37.8% and 51.4% of them were found to suffer from diabetes mellitus and hypertension respectively. Tobacco smoking, diabetes mellitus, and hypertension had shown significant association with the onset of young ACS (p ≤ 0.05). Conclusion: Three leading risk factors (tobacco smoking, diabetes mellitus, and hypertension) had been shown to be significantly associated with the onset of young ACS. Thus, it is important to identify this cohort and implement aggressive measures in tackling the risk factors in order to prevent or halt the development of coronary artery disease.
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Affiliation(s)
- Fan Kee Hoo
- Dr. Fan Kee Hoo, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yoke Loong Foo
- Dr. Yoke Loong Foo, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sazlyna Mohd Sazlly Lim
- Dr. Sazlyna Mohd Sazlly Lim, MRCP Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Siew Mooi Ching
- Dr. Siew Mooi Ching, MMed(FM). Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yang Liang Boo
- Dr. Boo Yang Liang, MRCP Hospital Enche' Besar Hajjah Khalsom, Jalan Kota Tinggi, 86000 Kluang, Johor, Malaysia
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Soeiro ADM, Fernandes FL, Soeiro MCFDA, Serrano CV, Oliveira MTD. Clinical characteristics and long-term progression of young patients with acute coronary syndrome in Brazil. EINSTEIN-SAO PAULO 2016; 13:370-5. [PMID: 26466059 PMCID: PMC4943781 DOI: 10.1590/s1679-45082015ao3381] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/20/2015] [Indexed: 12/27/2022] Open
Abstract
Objective In Brazil, there are few descriptions in the literature on the angiographic pattern and clinical characteristics of young patients with acute coronary syndrome, despite the evident number of cases in the population. The objective of this study was to evaluate which clinical characteristics are most closely related to the acute coronary syndrome in young patients, and what long-term outcomes are in this population. Methods This is a prospective observational study with 268 patients aged under 55 years with acute coronary syndrome, carried out between May 2010 and May 2013. Data were obtained on demographics, laboratory test and angiography results, and the coronary treatment adopted. Statistical analysis was presented as percentages and absolute values. Results Approximately 57% were men and the median age was 50 years (30 to 55). The main risk factors were arterial hypertension (68%), smoking (67%), and dyslipidemia (43%). Typical pain was present in 90% of patients. In young individuals, 25.7% showed ST segment elevation. Approximately 56.5% of patients presented with a single-vessel angiographic pattern. About 7.1% were submitted to coronary bypass surgery, and 42.1% to percutaneous coronary angioplasty. Intrahospital mortality was 1.5%, and the combined event rate (cerebrovascular accident/stroke, cardiogenic shock, reinfarction, and arrhythmias) was 13.8%. After a mean follow-up of 10 months, mortality was 9.8%, while 25.4% of the patients had new ischemic events, and 37.3% required readmission to hospital. Conclusion In the short-term, young patients presented with mortality rates below what was expected when compared to the rates noted in other studies. However, there was a significant increase in the number of events in the 10-month follow-up.
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Karim MA, Majumder AAS, Islam KQ, Alam MB, Paul ML, Islam MS, Chowdhury KN, Islam SMS. Risk factors and in-hospital outcome of acute ST segment elevation myocardial infarction in young Bangladeshi adults. BMC Cardiovasc Disord 2015. [PMID: 26197888 PMCID: PMC4509563 DOI: 10.1186/s12872-015-0069-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background South Asians have a higher overall incidence rate and younger age of onset for acute myocardial infarction (AMI) compared to Western populations. However, limited information is available on the association of preventable risk factors and outcomes of AMI among young individuals in Bangladesh. The aim of this study was to determine the risk factors and in-hospital outcome of AMI among young (age ≤40 years) adults in Bangladesh. Methods We conducted a prospective observational study among consecutive 50 patients aged ≤40 years and 50 patients aged >40 years with acute ST Segment Elevation Myocardial Infarction (STEMI) and followed-up in-hospital at the National Institute of Cardiovascular Diseases (NICVD). Clinical characteristics, biochemical findings, diet, echocardiography and in-hospital outcomes were compared between the two groups. Multivariate logistic regression was performed to assess the association between risk factors and in-hospital outcome in young patients adjusting for other confounding variables. Results The mean age of the young and older patient groups was 36.5 ± 4.6 years and 57.0 ± 9.1 years respectively. Male sex (OR 3.4, 95 % CI 1.2 − 9.75), smoking (OR 2.4, 95 % CI 1.04 − 5,62), family history of MI (OR 2.4, 95 % CI 1.11 − 5,54), homocysteine (OR 1.2, 95 % CI 1.08 − 1.36), eating rice ≥2 times daily (OR 3.5, 95 % CI 1.15 − 10.6) and eating beef (OR 4.5, 95 % CI 1.83 − 11.3) were significantly associated with the risk of AMI in the young group compared to older group. In multivariate analysis, older patients had significantly greater chance of developing heart failure (OR 7.5, 95 % CI 1.51 to 37.31), re-infarction (OR 7.0, 95 % CI 1.08 − 45.72), arrhythmia (OR 15.3, 95 % CI 2.69 − 87.77) and cardiogenic shock (OR 69.0, 95 % CI 5.81 − 85.52) than the younger group. Conclusion Younger AMI patients have a different risk profile and better in-hospital outcomes compared to the older patients. Control of preventable risk factors such as smoking, unhealthy diet, obesity and dyslipidemia should be reinforced at an early age in Bangladesh.
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Affiliation(s)
| | | | | | | | | | | | - Kamrun N Chowdhury
- Department of Epidemiology, National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh.
| | - Sheikh Mohammed Shariful Islam
- International Center for Diarrhoeal Disease Research, Bangladesh, Center for Control of Chronic Diseases, Dhaka, Bangladesh. .,Center for International Health, University of Munich, Munich, Germany. .,Cardiovascular Division, The George Institute for Global Health, Sydney, Australia.
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Panagiotakos DB, Notara V, Georgousopoulou EN, Pitsavos C, Antonoulas A, Kogias Y, Mantas Y, Stravopodis P, Zombolos S, Stefanadis C. A comparative analysis of predictors for 1-year recurrent acute coronary syndromes events, by age group: The Greek observational study of ACS (GREECS). Maturitas 2015; 80:205-11. [DOI: 10.1016/j.maturitas.2014.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 11/08/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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Feijó IP, Schmidt MM, David RB, Martins JMP, Schmidt KE, Gottschall CAM, Quadros ASD. Clinical profile and outcomes of primary percutaneous coronary intervention in young patients. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rbciev.2015.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Factors associated with coronary artery disease in young population (age ≤ 40): analysis with 217 cases. ACTA ACUST UNITED AC 2014; 29:38-42. [PMID: 24698677 DOI: 10.1016/s1001-9294(14)60022-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate the relevant factors of coronary artery disease (CAD) in young people under 40 years of age. METHODS The study population was 292 young patients accepting coronary angiography in Fuwai Hospital from July to December 2006, including 272 men and 20 women, with the mean age being 36.7 ± 3.7 years. The diagnosis of CAD was made in the cases presenting ≥ 50% stenosis in coronary lumen in coronary angiography. Based on the diagnosis, 217 patients (204 men, 13 women) were assigned to CAD group, and 75 (68 men, 7 women) to non-CAD group. Clinical data and metabolic characteristics of the patients were collected and analyzed using t-test, χ² test, and multinomial logistic regression with SPSS 8.0 software. RESULTS Most study subjects were current smokers (209/292, 71.6%), and more than half had body mass index (BMI)>24 kg/m² (230/292, 78.8%) and usually took high-fat diet (162/292, 55.5%). The proportion of heavy smokers (smoking history ≥ 10 years and ≥ 20 cigarettes per day) were significantly higher in the CAD group than in the non-CAD group [20.7% (45/217) vs. 9.3% (7/75), P=0.015)]. Heavy smoking [odds ratio (OR), 1.89; 95% confidence interval (CI), 1.74-2.05], hypertension (OR, 1.56; 95% CI, 1.48-1.65), alcohol (OR, 1.37; 95% CI, 1.30-1.46), type 2 diabetes mellitus (OR, 1.37; 95% CI, 1.25-1.50), high-fat diet (OR, 1.35; 95% CI, 1.28-1.43), and BMI>24 kg/m² (OR, 1.09; 95% CI, 1.03-1.17) were factors related to CAD in the young patients (all P<0.05). Total cholesterol (4.56 ± 1.46 mmol/L vs. 4.09 ± 1.00 mmol/L), low-density lipoprotein cholesterol (2.38 ± 1.11 mmol/L vs. 2.14 ± 0.63 mmol/L), lipoprotein a (134.97 ± 109.70 mg/L vs. 101.58 ± 58.39 mg/L), uric acid (359.89 ± 100.09 μmol/L vs. 336.75 ± 94.36 μmol/L), erythrocyte sedimentation rate (9.98 ± 12.19 mm/hour vs. 4.89 ± 4.92 mm/hour), high-sensitivity C-reactive protein (3.42 ± 4.39 mg/L vs. 2.80 ± 3.77 mg/L) and Big endothelin-1 (1.41 ± 1.50 fmol/mL vs. 0.77 ± 1.13 fmol/mL) in plasma were significantly increased in the CAD group compared with the non-CAD group (all P<0.05). CONCLUSIONS Heavy smoking, hypertension, alcohol consumption, type 2 diabetes mellitus, high-fat diet and BMI>24 kg/m² were significantly related to CAD in patients aged ≤ 40, with heavy smoking presenting the highest OR. Metabolic syndrome and inflammation were also more common in young CAD patients than in non-CAD patients.
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Jinnouchi H, Sakakura K, Wada H, Kubo N, Sugawara Y, Funayama H, Ako J, Momomura SI. Clinical features of myocardial infarction in young Japanese patients. Int Heart J 2013; 54:123-8. [PMID: 23774233 DOI: 10.1536/ihj.54.123] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical features and outcomes of acute myocardial infarction (AMI) in the young have been poorly investigated. The aim of this study was to investigate the clinical features and hospital outcomes of AMI in young Japanese. We conducted a case-control study. A total of 53 consecutive AMI patients whose age was ≤ 45 years old were assigned to the young group and 106 AMI patients whose age was > 45 years old were assigned to the non-young group. We compared the clinical features and hospital outcomes between the two groups. Compared with the non-young group, the young group was associated with male sex, hyperlipidemia, current smoking, being overweight, single vessel disease, and Killip class I on admission. There were no differences in the length of hospital stay or major adverse cardiac events between the groups. However, mortality and ventricular rupture were slightly lower in the young. In conclusion, young AMI patients had clinical characteristics different to those of the non-young patients. Compared to non-young patients, modifiable risk factors such as smoking, hyperlipidemia, and being overweight were associated with young AMI patients.
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Affiliation(s)
- Hiroyuki Jinnouchi
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Japan
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Otaki Y, Gransar H, Berman DS, Cheng VY, Dey D, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJ, Delago A, Hadamitzky M, Hausleiter J, Kaufmann P, Maffei E, Raff G, Shaw LJ, Villines TC, Dunning A, Min JK. Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry). Am J Cardiol 2013; 111:1081-6. [PMID: 23411105 DOI: 10.1016/j.amjcard.2012.12.042] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 12/12/2012] [Accepted: 12/12/2012] [Indexed: 02/08/2023]
Abstract
Although family history (FH) of coronary artery disease (CAD) is considered a risk factor for future cardiovascular events, the prevalence, extent, severity, and prognosis of young patients with FH of CAD have been inadequately studied. From 27,125 consecutive patients who underwent coronary computed tomographic angiography, 6,308 young patients (men aged <55 years and women aged <65 years) without known CAD were identified. Obstructive CAD was defined as >50% stenosis in a coronary artery >2 mm diameter. Risk-adjusted logistic regression, Kaplan-Meier, and Cox proportional-hazards models were used to compare patients with and without FH of CAD. Compared with subjects without FH of CAD, those with FH of CAD (FH+) had higher prevalences of any CAD (40% vs 30%, p <0.001) and obstructive CAD (11% vs 7%, p <0.001), with multivariate odds of FH+ increasing the likelihood of obstructive CAD by 71% (p <0.001). After a mean follow-up period of 2 ± 1 years (42 myocardial infarctions and 39 all-cause deaths), FH+ patients experienced higher annual rates of myocardial infarction (0.5% vs 0.2%, log-rank p = 0.001), with a positive FH the strongest predictor of myocardial infarction (hazard ratio 2.6, 95% confidence interval 1.4 to 4.8, p = 0.002). In conclusion, young FH+ patients have higher presence, extent, and severity of CAD, which are associated with increased risk for myocardial infarction. Compared with other clinical CAD risk factors, positive FH in young patients is the strongest clinical predictor of future unheralded myocardial infarction.
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Panduranga P, Sulaiman K, Al-Zakwani I, Abdelrahman S. Acute coronary syndrome in young adults from oman: results from the gulf registry of acute coronary events. Heart Views 2011; 11:93-8. [PMID: 21577375 PMCID: PMC3089825 DOI: 10.4103/1995-705x.76799] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the prevalence, risk factors, presenting features, and in-hospital outcomes of acute coronary syndrome (ACS) patients ≤40 years of age from Oman. METHODS Data were analyzed from 1579 consecutive ACS patients from Oman during May, 2006 to June, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). ACS patients ≤40 years of age were compared with patients >40 years of age. RESULTS A total of 121 (7.6%) patients were ≤40 years of age with mean age of 36 ± 4 vs. 61 ± 11 years in young and old adults, respectively (P<0.001). More men were seen in the younger age group (81 vs. 60%; P<0.001). Among all the coronary risk factors, young patients had more history of smoking (47 vs. 15%; P<0.001), obesity (72 vs. 58%; P = 0.009), and family history of coronary artery disease (CAD) (16 vs. 7%; P = 0.001). Both groups received aspirin, statins, thrombolytic therapy, and anticoagulants equally; however, younger patients received clopidogrel, glycoprotein IIb/IIIa inhibitors, β-blockers, and in-hospital coronary angiogram more. Younger patients experienced less heart failure (6 vs. 27%; P<0.001) and in-hospital mortality, especially among STEMI patients (0 vs. 10%; P = 0.037). CONCLUSIONS Young ACS patients from Oman have different risk profile. They were treated more aggressively and their outcome was better, which is similar to other populations. However, smoking, along with obesity and family history of CAD were strong risk factors in the young Omani ACS patients. There is a need for prevention programmes to control smoking and obesity epidemic by targeting young adults in the population.
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Alanbaei M, Zubaid M, Al-Mallah MH, Rashed WA, Shehab A, Al-Lawati J, ChB MB, Amin H, Suwaidi JA, Al-Hamdan R, Zubair S. Impact of Diabetes and Smoking Epidemic in the Middle East on the Presentation With Acute Coronary Syndrome in Very Young Patients. Angiology 2011; 63:48-54. [DOI: 10.1177/0003319711406255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe the baseline characteristics, management, and outcomes of acute coronary syndrome (ACS) in patients of age ≤40 in the Gulf region of the Middle East. We studied 8176 hospitalized patients (≤40 years) with ACS. Ten percent (805) of the recruited patients were ≤40 years. The mean age was 37 years and 89% were males. The prevalence of smoking and diabetes in the young patients was high (58% and 21%, respectively). The most common ACS was ST elevation myocardial infarction. Younger patients were more aggressively treated with more frequent use of glycoprotein inhibitors, thrombolytics, and primary percutaneous coronary intervention. They had less in-hospital heart failure, left ventricular dysfunction, shock, stroke, and low rate of in-hospital mortality (1%). Measures to combat the rising prevalence of diabetes and smoking are needed.
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Affiliation(s)
- Muath Alanbaei
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Mohammad Zubaid
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Mouaz H. Al-Mallah
- Wayne State University School of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Wafa A Rashed
- Department of Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya, Kuwait
| | | | | | - MB ChB
- Department of Non-communicable Diseases Control, Ministry of Health, Muscat, Oman
| | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain
| | | | - Rashed Al-Hamdan
- Department of Medicine, Jahra Hospital, Ministry of Health, Al-Jahra, Kuwait
| | - Shahid Zubair
- Department of Medicine, Kuwait Oil Company Hospital, Kuwait
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16
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK, Smith SC, Anderson JL, Albert N, Buller CE, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Nishimura R, Ohman EM, Page RL, Stevenson WG, Tarkington LG, Yancy CW. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2011; 56:e50-103. [PMID: 21144964 DOI: 10.1016/j.jacc.2010.09.001] [Citation(s) in RCA: 1001] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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17
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2010; 122:e584-636. [PMID: 21098428 DOI: 10.1161/cir.0b013e3182051b4c] [Citation(s) in RCA: 402] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Cho JY, Jeong MH, Ahn Y, Chae SC, Seong IH, Kim YJ, Yoon J, Rhew JY, Chae JK, Chae IH, Lee NH, Hwang JY, Cho MC, Kim KS, Kim CJ, Chung WS, Rha SW, Jang YS, Seung KB, Park SJ. Predictive Factors of Major Adverse Cardiac Events and Clinical Outcomes of Acute Myocardial Infarction in Young Korean Patients. Korean Circ J 2008. [DOI: 10.4070/kcj.2008.38.3.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jae Yeong Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myung Ho Jeong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Youngkeun Ahn
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Shung Chull Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Hwan Seong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Young Jo Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Junghan Yoon
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jay Young Rhew
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jei Keon Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Ho Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Nae Hee Lee
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jin Yong Hwang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myeong Chan Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Kee Sik Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Chong Jin Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Wook Sung Chung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Woon Rha
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Yang Soo Jang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Ki Bae Seung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Jung Park
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
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Shiraishi J, Kohno Y, Sawada T, Arihara M, Hyogo M, Yagi T, Shima T, Okada T, Nakamura T, Matoba S, Yamada H, Shirayama T, Tatsumi T, Kitamura M, Furukawa K, Matsubara H, The AMI-Kyoto Multi-Center Risk Study Group. Effects of Hospital Volume of Primary Percutaneous Coronary Interventions on Angiographic Results and In-Hospital Outcomes for Acute Myocardial Infarction. Circ J 2008; 72:1041-6. [DOI: 10.1253/circj.72.1041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takahisa Sawada
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Masayasu Arihara
- Department of Emergency Medicine, Kyoto First Red Cross Hospital
| | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takakazu Yagi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takatomo Shima
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takashi Okada
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takeshi Nakamura
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Satoaki Matoba
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Hiroyuki Yamada
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Takeshi Shirayama
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Tetsuya Tatsumi
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | | | | | - Hiroaki Matsubara
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
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20
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Shiraishi J, Kohno Y, Sawada T, Takeda M, Arihara M, Hyogo M, Yagi T, Shima T, Okada T, Nakamura T, Matoba S, Yamada H, Shirayama T, Kitamura M, Furukawa K, Matsubara H, The AMI-Kyoto Multi-Center Risk Study Group. Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction. Circ J 2008; 72:1225-9. [DOI: 10.1253/circj.72.1225] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takahisa Sawada
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Mitsuo Takeda
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Masayasu Arihara
- Department of Emergency Medicine, Kyoto First Red Cross Hospital
| | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takakazu Yagi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takatomo Shima
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takashi Okada
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takeshi Nakamura
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Satoaki Matoba
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Hiroyuki Yamada
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | - Takeshi Shirayama
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
| | | | | | - Hiroaki Matsubara
- Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
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21
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Comparison of clinical characteristics and arterial remodeling by intravascular ultrasonic imaging in three age groups (< or =55, 56 to 69 and > or =70 years) of Japanese patients with acute myocardial infarction. Am J Cardiol 2007; 100:1713-7. [PMID: 18082513 DOI: 10.1016/j.amjcard.2007.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2007] [Revised: 07/03/2007] [Accepted: 07/03/2007] [Indexed: 12/31/2022]
Abstract
Recent epidemiologic, pathologic, and intravascular ultrasound (IVUS) studies have shown that there are differences in coronary risk factors or plaque morphology between younger and older patients with acute myocardial infarctions (AMIs). This study examined clinical background and plaque morphology using IVUS in younger and older adults with AMIs in Japan. The study population consisted of 96 patients with AMIs, for whom preinterventional IVUS images were obtained. Patients were classified into 3 groups: a young group (aged < or =55 years), a middle-aged group (aged 56 to 69 years), and an old group (aged > or =70 years). The remodeling index was defined as the ratio of the external elastic membrane area at the culprit lesion to the external elastic membrane area at the proximal reference site. Expansive remodeling was defined as a remodeling index >1.05 and constrictive remodeling as a remodeling index <0.95. The frequency of hypercholesterolemia was significantly different among the 3 age groups. Total cholesterol (p <0.001), low-density lipoprotein cholesterol (p <0.005), and triglyceride (p <0.05) levels and body mass index (p <0.001) in the young group were significantly higher than in the old group. On IVUS images, constrictive remodeling was most common in the young group, whereas expansive remodeling occurred most commonly in the middle-aged and old groups. In conclusion, this study demonstrated that patients with AMIs in the young group had higher levels of hypercholesterolemia, obesity, and constrictive remodeling compared with those in the old group. The differences in arterial remodeling of the culprit lesions between younger and older patients with AMIs may reflect different biologic mechanisms of plaque activation and destabilization.
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22
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Ueda Y, Okada K, Ogasawara N, Oyabu J, Hirayama A, Kodama K. Acute myocardial infarction without disrupted yellow plaque in young patients below 50 years old. J Interv Cardiol 2007; 20:177-81. [PMID: 17524108 DOI: 10.1111/j.1540-8183.2007.00259.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Thrombosis caused by disrupted yellow plaque is regarded as a cause of acute myocardial infarction (MI). However, it has not been clarified if young patients have the same pathophysiology as older ones. Therefore, we elucidated clinical and angioscopic characteristics of young patients. METHODS Among a series of patients (n = 893) who received catheterization for acute MI, clinical characteristics were compared between patients <50 years (n = 66) and the rest of patients. Angioscopic appearance of culprit lesions was evaluated in 20 young patients in whom angioscopic examination was successfully performed. It was determined if culprit lesions had disrupted yellow plaque with thrombus (DYP&T). RESULTS Patients <50 years had higher prevalence of smoking (68% vs. 48%, P = 0.001), obesity (42% vs. 15%, P < 0.0001), and hypercholesterolemia (56% vs. 35%, P = 0.0005) than those >or=50 years. DYP&T was detected at culprit lesions in 14 (70%) patients. Prevalence of DYP&T was lower in patients <40 years (44% vs. 91%, P = 0.02) than those between 40 and 50 years. Patients <40 years had a trend for higher prevalence of smoking (88% vs. 62%, P = 0.05) than those between 40 and 50 years. CONCLUSIONS Patients with acute MI < 50 years, especially <40 years, had lower prevalence of DYP&T but higher prevalence of smoking, obesity, and hypercholesterolemia. Smoking may play an important role for thrombotic occlusion at lesions with relatively low thrombogenic potential.
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Affiliation(s)
- Yasunori Ueda
- Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
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23
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Yasunaga T, Koga S, Ikeda S, Yasuoka C, Sonoda Y, Tanioka Y, Kohno S. Cluster differentiation-36 deficiency type 1 and acute coronary syndrome without major cardiovascular risk factors: case report. Circ J 2007; 71:166-9. [PMID: 17186996 DOI: 10.1253/circj.71.166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 45-year-old man without major coronary risk factors, including hypertension, diabetes mellitus, smoking, hypercholesterolemia, hyperuricemia, or a family history of early cardiovascular disease, presented with acute coronary syndrome. Angiography showed thrombus formation in segment 7 of the left anterior descending coronary artery, and percutaneous coronary intervention was successful after implantation of a bare metal stent. Scintigraphy showed the absence of 123I-beta-methyl-iodophenyl pentadecanoic acid accumulation in the myocardium. Flow cytometric analysis of platelets and monocytes showed the absence of cluster differentiation (CD)-36 expression. These findings are consistent with a diagnosis of CD36 deficiency type 1, which might be associated with cardiovascular disease. The patient had no apparent major coronary risk factors except for insulin resistance and an abnormal lipoprotein profile. The findings suggest that in this case the CD36 deficiency type 1 was the pathogenic mechanism of acute coronary syndrome relative to insulin resistance and modification of the lipid profile.
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Affiliation(s)
- Tomohiko Yasunaga
- Cardiovascular Center, Omura Municipal Hospital, Second Department of Internal Medicine, School of Medicine, Nagasaki University, Japan
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24
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Cho JY, Jeong MH, Choi OJ, Lee S, Jeong SY, Kim IS, Cho JS, Hwang SH, Hwang SH, Yoon NS, Moon JY, Hong YJ, Kim JH, Kim W, Ahn YK, Cho JG, Park JC, Kang JC. Predictive Factors after Percutaneous Coronary Intervention in Young Patients with Acute Myocardial Infarction. Korean Circ J 2007. [DOI: 10.4070/kcj.2007.37.8.373] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jae Yeong Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Ok Ja Choi
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seok Lee
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seon Young Jeong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - In Soo Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung Sun Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seung Hwan Hwang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Sun Ho Hwang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Nam Sik Yoon
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jae Youn Moon
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Ju Han Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Weon Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Young Keun Ahn
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jeong Gwan Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jong Chun Park
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
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25
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Shiraishi J, Kohno Y, Sawada T, Nishizawa S, Arihara M, Hadase M, Hyogo M, Yagi T, Shima T, Okada T, Matoba S, Yamada H, Tatsumi T, Kitamura M, Furukawa K, Matsubara H. In-Hospital Outcomes of Primary Percutaneous Coronary Interventions Performed at Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery. Circ J 2007; 71:1208-12. [PMID: 17652882 DOI: 10.1253/circj.71.1208] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is performed in hospitals without on-site coronary artery bypass graft surgery in the ;real world'. However, data on the in-hospital outcomes of primary PCI performed at hospitals with and without on-site cardiac surgery are still lacking in Japan. METHODS AND RESULTS In the present study, 2,230 AMI patients were enrolled in the AMI-Kyoto Multi-Center Risk Study between January 2000 and December 2005. Of these, 1,817 patients underwent primary PCI. Excluding patients without adequate data, we retrospectively compared clinical background, coronary risk factors, angiographic findings, acute results of primary PCI and in-hospital prognosis between patients undergoing primary PCI in hospitals without on-site cardiac surgery (without surgery group, n=792) and those in hospitals with (with surgery group, n=993). The without surgery group had higher prevalence of previous myocardial infarction, Killip class>or=3 at admission and multivessels as a culprit lesion than the with surgery group. The without surgery group was more likely to have lower frequency of stent usage and lower thrombolysis in myocardial infarction flow grade just after PCI, whereas it was more likely to have intra-aortic balloon pumping and temporary pacing during procedures. The overall in-hospital mortality did not differ between the 2 groups. On multivariate analysis, in AMI patients undergoing primary PCI, Killip class>or=3 at admission, multivessels or left main trunk (LMT) as culprit lesions, number of diseased vessels>or=2 or diseased LMT, and age were the independent predictors of the in-hospital mortality, but the presence of on-site cardiac surgery was not. CONCLUSIONS These results suggest that in-hospital outcomes in AMI patients undergoing primary PCI at hospitals without on-site cardiac surgery are comparable to those at hospitals with on-site cardiac surgery in Japan.
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Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital, and Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine, Japan.
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Shiraishi J, Kohno Y, Sawada T, Nishizawa S, Arihara M, Hadase M, Hyogo M, Yagi T, Shima T, Nakazawa A, Shigeta M, Yamada H, Tatsumi T, Azuma A, Matsubara H. Relation of Obesity to Acute Myocardial Infarction in Japanese Patients Differences in Gender and Age. Circ J 2006; 70:1525-30. [PMID: 17127793 DOI: 10.1253/circj.70.1525] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It remains uncertain whether obesity is an independent risk factor for coronary heart disease in young adults, as well as adults, in Japan. METHODS AND RESULTS In the present study, 1,260 cases of acute myocardial infarction (AMI) and 3,775 community controls were recruited from the AMI-Kyoto Multi-Center Risk Study and Kyoto Citizen's Health and Nutrition Study, respectively. Obesity and other risk factors were retrospectively examined between cases and controls in each subgroup of young males (20-40 years), middle-aged males or females (40-60 years), older males or females (60-80 years), and very old males or females (80-100 years). In young, middle-aged, and older males, as well as in older females, cases had a higher body mass index (BMI) than controls. In young males, as well as in middle-aged and older females, cases had a higher prevalence of smoking than controls. Except for very old males, the prevalences of hypercholesterolemia, hypertension, and diabetes mellitus were higher in each subgroup of cases than in controls. Multivariate logistic regression analysis revealed that obesity (BMI >or=25) was an independent risk for AMI in young and middle-aged males, but not in females, whereas smoking was an independent risk for AMI in middle-aged and older females as well as in older males. CONCLUSIONS Obesity is significantly associated with AMI, independent of the classic coronary risk factors, in young and middle-aged males. These findings support the current emphasis on controlling obesity to prevent coronary events in young Japanese male adults.
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Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital, Japan.
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Shiraishi J, Kohno Y, Yamaguchi S, Arihara M, Hadase M, Hyogo M, Yagi T, Shima T, Sawada T, Tatsumi T, Azuma A, Matsubara H. Medium-Term Prognosis of Young Japanese Adults Having Acute Myocardial Infarction. Circ J 2006; 70:518-24. [PMID: 16636483 DOI: 10.1253/circj.70.518] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Data on the medium- and long-term prognosis of young Japanese patients with acute myocardial infarction (AMI) are still lacking. METHODS AND RESULTS In the present study, 1,458 AMI patients were enrolled in the AMI-Kyoto Multi-Center Risk Study between January 2000 and December 2003. Of these, clinical characteristics and medium-term prognosis were retrospectively compared in 21 young patients < 40 years (young group), and 190 non-young patients 60-70 years old (non-young group) who could be followed after hospital discharge. The young group was all male and had higher prevalence of current smoking and greater body mass index, but previous myocardial infarction (MI) and hypertension were more prevalent in the non-young group. The young group had a higher prevalence of single-vessel disease and a lesser incidence of left circumflex coronary artery as the culprit lesion. The acquisition rates of Thrombolysis In Myocardial Infarction 3 flow after primary percutaneous coronary intervention did not differ between the 2 groups, but the data of maximal creatine kinase was significantly higher in the young group. During the follow-up period (average 2.42 years for young, 2.37 years for non-young), survival and event-free survival rates and incidence of major adverse cardiac events (MACE) did not differ between the 2 groups. The predictor of MACE during follow-up period was the presence of multivessel disease in the young group, whereas the presence of multivessel disease, history of previous MI and longer hospitalization were the predictors of MACE in the non-young group. CONCLUSIONS These results suggest that the medium-term prognosis in young AMI patients is comparable to that of non-young AMI patients in Japan.
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Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital, Kyoto, Japan.
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