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Yılmaz S, Coşansu K. Prognostic Factors and Outcomes in Young Patients With Presented of Different Types Acute Coronary Syndrome. Angiology 2020; 71:894-902. [DOI: 10.1177/0003319720939444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The prevalence of coronary artery disease is increasing in young adults. We evaluated the outcomes of different types of acute coronary syndrome in 917 patients undergoing coronary angiography aged ≤45 years. Male sex, smoking, dyslipidemia were the most important risk factors. ST-elevation myocardial infarction (STEMI; 54.8%) predominated. The STEMI patients had higher risk of hospital mortality (3.6% vs 0.6%; P = .004) and major adverse cardiac and cerebrovascular events (MACCE; 13.8% vs 3.3%; P < .001, hazard ratio [HR], 4.65; 95% CI, 2.45-8.82). Presentation heart rate, blood pressure, heart failure, shock, arrhythmia, ejection fraction (EF), diabetes, contrast-induced nephropathy (CIN), and elevated troponin were associated with hospital mortality and MACCE. But only heart failure (HR, 5.816; 95% CI, 2.254-15.008) and CIN (HR, 6.241; 95% CI, 2.340-16.641) were independent risk factors for hospital MACCE. There was no difference in long-term mortality between the 2 groups, but non-STEMI patients had higher risk for MACCE after 3 years (14.4% vs 9.9%, P = .033). Although shock (HR, 0.814; 95% CI, 0.699-0.930), Killip class ≥2 (HR, 0.121; 95% CI, 0.071-0.170), CIN (HR, 0.323; 95% CI, 0.265-0.380), and EF (HR, 0.917; 95% CI, 0.854-0.984) were independent predictors of hospital death, only EF was the independent predictor of long-term mortality (HR, 0.897; 95% CI, 0.852-0.944).
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Affiliation(s)
- Sabiye Yılmaz
- Department of Cardiology, Sakarya University Education and Research Hospital, Sakarya, Turkey
| | - Kahraman Coşansu
- Department of Cardiology, Sakarya University Education and Research Hospital, Sakarya, Turkey
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Zhang X, Yu Q, Yao X, Liu G, Li J, Du L. Effects of Nicorandil on All-Cause Mortality and Cardiac Events in CAD Patients Receiving PCI. Int Heart J 2019; 60:886-898. [PMID: 31308321 DOI: 10.1536/ihj.18-337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University
| | - Qian Yu
- Medical Affairs, Merck Serono Co. Ltd
| | - Xun Yao
- West China School of Medicine, Sichuan University
| | - Guanjian Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University
| | - Jing Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University
- West China Medical Publishers, West China Hospital, Sichuan University
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Liu Y, Han T, Gao M, Wang J, Liu F, Zhou S, Chen Y. Clinical characteristics and prognosis of acute myocardial infarction in young smokers and non-smokers (≤ 45 years): a systematic review and meta-analysis. Oncotarget 2017; 8:81195-81203. [PMID: 29113379 PMCID: PMC5655274 DOI: 10.18632/oncotarget.21092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 09/04/2017] [Indexed: 11/25/2022] Open
Abstract
The effect of smoking on the prognosis of young patients with acute myocardial infarction (AMI) is inconclusive. We enrolled 2188 young AMI patients (≤ 45 years) from the cardiac center of the Chinese PLA General Hospital and Anzhen Hospital and analyzed their clinical characteristics and prognosis. We also searched the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials electronic databases for January 2001 to March 2017 and considered for inclusion in a meta-analysis those clinical trials that compared prognoses of young smokers and non-smokers with AMI. The proportion of males and alcohol users was higher in young AMI smokers than in non-smokers; the proportion of hypertension was slightly lower. There was no difference in medical treatment between smokers and non-smokers. No differences were evident between smokers and non-smokers regarding in-hospital cardiac events and major adverse cardiovascular events on follow-up, including incidence of stroke. For young AMI patients, smoking did not lead to poorer prognosisin comparison with not smoking. This “smoker's paradox” needs to be confirmed by more randomized controlled multicenter prospective clinical trials.
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Affiliation(s)
- Yuqi Liu
- Department of Cardiology, PLA General Hospital, Beijing 100853, China
| | - Tianwen Han
- Department of Cardiology, PLA General Hospital, Beijing 100853, China
| | - Ming Gao
- ICU of The First Phase Beijing Tsinghua Changgeng Hospital, Beijing 100044, China
| | - Jinwen Wang
- Department of Cardiology of Anzhen Hospital, Beijing 100029, China
| | - Fang Liu
- Department of Cardiology of Anzhen Hospital, Beijing 100029, China
| | - Shanshan Zhou
- Department of Cardiology, PLA General Hospital, Beijing 100853, China
| | - Yundai Chen
- Department of Cardiology, PLA General Hospital, Beijing 100853, China
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Comparison of Long-Term Mortality of Patients Aged ≤40 Versus >40 Years With Acute Myocardial Infarction. Am J Cardiol 2016; 118:319-25. [PMID: 27328956 DOI: 10.1016/j.amjcard.2016.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/04/2016] [Accepted: 05/04/2016] [Indexed: 11/24/2022]
Abstract
Young patients with acute myocardial infarction (MI) have a more favorable prognosis than older patients with MI. However, there are limited data comparing the prognosis of young patients with MI with young population controls. Comparison with an age-matched background population could unmask residual mortality risk in young patients with MI that would otherwise not be apparent when merely comparing the mortality risk of young and older patients with MI. We studied 15,151 patients with AMI from 2000 to 2005, of which 601 patients were ≤40 years (young MI). The relative survival ratio (RSR) was calculated as the ratio of the observed survival of patients with MI divided by the expected survival, estimated from the background population (n = 3,771,700) matched for age, gender, and follow-up year. An RSR of <1.0 or >1.0 indicates poorer or better survival, respectively, than the background population. The 12-year all-cause and cardiovascular mortality of young versus older patients was 12.8% versus 50.7% (p <0.001) and 9.2% versus 34.5% (p <0.001), respectively. The adjusted hazard ratio (95% confidence interval) for all-cause and cardiovascular mortality comparing young with older patients was 0.20 (0.16 to 0.27) and 0.27 (0.20 to 0.36), respectively. The RSR (95% confidence interval) of young and older patients was, respectively, 0.969 (0.950 to 0.980) and 0.804 (0.797 to 0.811) at 1 year, 0.942 (0.918 to 0.960) and 0.716 (0.707 to 0.726) at 5 years, and 0.908 (0.878 to 0.938) and 0.638 (0.620 to 0.654) at 9 years. In conclusion, despite a fivefold lower long-term mortality than older patients with MI, young patients with MI remain at significantly greater risk of long-term mortality than an age-matched background population.
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Qian G, Zhou Y, Liu HB, Chen YD. Clinical Profile and Long-Term Prognostic Factors of a Young Chinese Han Population (≤ 40 Years) Having ST-Segment Elevation Myocardial Infarction. ACTA CARDIOLOGICA SINICA 2016; 31:390-7. [PMID: 27122898 DOI: 10.6515/acs20140929d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The proportion of the mainland Chinese population with premature ST-segment elevation myocardial infarction is significantly elevated. Young patients with ST-segment elevation myocardial infarction have a different risk factor profile and clinical outcome compared with elder patients, and may also differ as compared to young patients in Western populations. METHODS We analyzed a total of 9462 consecutive ST-segment elevation myocardial infarction patients, and recruited 341 consecutive cases who had survived their first ST-segment elevation myocardial infarction at the age less than 40 years, and followed-up these patients for 5 years. RESULTS The most prevalent risk factor in young Chinese ST-segment elevation myocardial infarction patients was smoking (307/341, 90.03%) and male gender (328/341, 96.19%), although young patients had fewer traditional risk factors of acute myocardial infarction than the control group [(1.63 ± 1.03) vs. (2.38 ± 1.15), p < 0.01]. The number of affected vessels in cases was significantly less than in the elder control group (p < 0.01). During the follow-up, blood lipids and blood pressure of most patients reached the target level, while 42.10% of patients reported continuation of smoking. Multivariable data analysis showed that persistence of smoking (OR: 3.784, 95% CI: 1.636-8.751, p < 0.01) was the most significant prognostic factor of cardiac events after adjusting for various confounding factors. CONCLUSIONS We demonstrated that cigarette smoking is the most prevalent factor among the avoidable cardiovascular risk factors for young ST-segment elevation myocardial infarctions in China. Accordingly, continued smoking is the most powerful predictor for the recurrence of cardiac events in young Chinese patients with ST-segment elevation myocardial infarction. KEY WORDS Premature myocardial infarction; Prognosis; Risk factor.
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Affiliation(s)
- Geng Qian
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ying Zhou
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Hong-Bin Liu
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yun-Dai Chen
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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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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Alappatt NJ, Sailesh KS, Mukkadan JK. Clinical Profile of Acute Coronary Syndrome in Young Adults. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2016. [DOI: 10.46347/jmsh.2016.v02i01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Li Q, Guo J, Cao XQ, Yuan X, Rao KQ, Zheng Z, Liu ZD, Hu SS. Trend of non-communicable disease mortality for three common conditions in the elderly population from 2002 to 2010: A population-based study in China. Chronic Dis Transl Med 2015; 1:152-157. [PMID: 29063001 PMCID: PMC5643572 DOI: 10.1016/j.cdtm.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Indexed: 12/22/2022] Open
Abstract
Objective There is a lack of data focusing on non-communicable disease (NCD) mortality in the Chinese elderly population over the past decade. Methods Using mortality data from the Chinese Health Statistics, we explored the crude and age-standardized mortality trend of three major NCDs in the Chinese population ≥65 years of age from 2002 to 2010, namely, malignant neoplasms, heart diseases, and cerebrovascular diseases. Subpopulations characterized as rural and urban residence, and by gender and age were examined separately. Results Mortality increased with age and was higher among males than among females across the three NCDs, with the gender difference being most remarkable for malignant neoplasms and least for heart diseases mortality. Condition-specific crude mortalities increased between 2002 and 2010, overall and in all the pre-specified subpopulations. After age-standardization, rising trends were observed for people ≥65 years old, and condition-specific mortalities generally increased in rural regions and decreased in urban regions, especially for cerebrovascular diseases. Conclusions There were increasing trends for mortality due to malignant neoplasms, heart diseases, and cerebrovascular diseases in China between 2002 and 2010, which were largely driven by the population aging. Disparities existed by rural and urban residence, gender, and age.
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Affiliation(s)
- Qian Li
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Jin Guo
- School of Public Health, Capital Medical University, Beijing 100000, China
| | - Xiao-Qing Cao
- Department of Thoracic Surgery, Beijing Chest Hospital, Beijing 100000, China
| | - Xin Yuan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing 100037, China.,Department of Cardiac Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Ke-Qin Rao
- Center for Health Statistics, National Health and Family Planning Commission of China, Beijing 100037, China
| | - Zhe Zheng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing 100037, China.,Department of Cardiac Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Zhi-Dong Liu
- Department of Thoracic Surgery, Beijing Chest Hospital, Beijing 100000, China
| | - Sheng-Shou Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing 100037, China.,Department of Cardiac Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
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Al-Murayeh MA, Al-Masswary AA, Dardir MD, Moselhy MS, Youssef AA. Clinical presentation and short-term outcome of acute coronary syndrome in native young Saudi population. J Saudi Heart Assoc 2012; 24:169-75. [PMID: 23960691 DOI: 10.1016/j.jsha.2012.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 02/12/2012] [Accepted: 03/04/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To investigate acute coronary syndromes (ACS) in the young Saudi population in Aseer Region, southwestern Saudi Arabia. MATERIALS AND METHODS We retrospectively reviewed our database between January 2006 and May 2009, 924 patients were diagnosed to have ACS. Among them 107 patients (11.6%) met our definition of young [66 (61.7%) male < 45 years, and 41 (38.3%) female < 55 years]. We compared this study population to a control group of 50 elderly patients consecutively enrolled in a contemporary period. RESULTS The overall age was 42.3 ± 7.9 and 68.7 ± 10.1 years in the study population and control respectively. 100% of the population and 92% of the control group presented with chest pain. Diabetes mellitus (DM) prevalence was 46.7% in the study population (63.4% in females), and 62% in the control group. Hypertension, smoking, dyslipidemia and overweight/obesity were reported in 31.8%, 25.2%, 21.5% and 44.9% of the study population and 58%, 6%, 26% and 42% of the control group, respectively. Past history of coronary artery disease was documented in 16.8% of the study population and 38% of the control group. The discharge diagnoses were ST-segment elevation myocardial infarction (STEMI) in 41 (38.3%) (representing 4.4% of the whole ACS population) and 11 (22%) patients of the study population and control group respectively, non-ST-segment elevation myocardial infarction in 36 (33.6%) and 23 (46%) patients of the study population and control group, respectively, and unstable angina in 30 (28.0%) and 15 (30%) patients of the study population and control group, respectively. Coronary angiography was performed in 86 (80.4%) and 41 (82%) patients in the study population and control group respectively. In hospital, one young patient had acute ischemic stroke and one elderly patient died, 22.4% of the study population and 32% of control group were discharged with clinical diagnosis of heart failure or in need for diuretics. CONCLUSION In our study, the young Saudi population with ACS had chest pain as the leading symptom. STEMI was the major final diagnosis and among one of the highest reported worldwide. There is a high prevalence of DM; however, they have favorable in hospital and short-term outcome.
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Affiliation(s)
- Mushabab A Al-Murayeh
- Cardiology Department, Armed Forces Hospital, Southern Region, P.O. Box 101, Khamis Mushayt
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Manzur F, España H, Dueñas C. Variables asociadas a mortalidad por infarto del miocardio en adultos mayores de 75 años en Cartagena de Indias, Colombia: un estudio piloto. REVISTA COLOMBIANA DE CARDIOLOGÍA 2011. [DOI: 10.1016/s0120-5633(11)70186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Comparison of outcomes in young versus nonyoung patients with ST elevation myocardial infarction treated by primary angioplasty. Coron Artery Dis 2010; 21:72-7. [DOI: 10.1097/mca.0b013e328334a0f6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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