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Qiao S, Wang W, Chen X, Cao X. Profiles of work ability and associated factors in young and middle-aged acute myocardial infarction patients: A latent profile analysis. Heart Lung 2024; 66:108-116. [PMID: 38604054 DOI: 10.1016/j.hrtlng.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The incidence of acute myocardial infarction (AMI) is increasing among young and middle-aged people, and such patients need to be reemployed after AMI events from the individual and society perspectives. However, the situation of employment after AMI was not ideal. Early identification of patients vulnerable to decreased work ability and provided targeted intervention may be beneficial. OBJECTIVE To identify the profiles and associated factors of work ability in young and middle-aged AMI patients. METHODS A cross-sectional study was conducted in Guangzhou, China, from September 2022 to October 2023. Work ability, self-efficacy for return-to-work, social support, anxiety, and depression were measured by the Work-ability Support Scale (WSS), Return-To-Work Self-Efficacy Questionnaire, Social Support Rating Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire 9, respectively. We performed latent profile analysis based on three subdomains of the WSS by using Mplus 8.3. Multiple logistic regression was used to identify factors associated with work ability. RESULTS A total of 155 participants (aged 48.58±7.153 years, 95.5 % male) were included. We identified three latent profiles of work ability: low work ability (28.1 %), moderate work ability (51 %), and high work ability (20.6 %). The per capita monthly household income, NYHA functional class, total cholesterol, length of hospital stay, social support, and self-efficacy for return-to-work were factors associated with work ability. CONCLUSION This study demonstrated different profiles and associated factors of work ability in young and middle-aged AMI patients. It is suggested that healthcare providers identify and monitor associated factors to improve work ability among this subpopulation.
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Affiliation(s)
- Shuqian Qiao
- The School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Wei Wang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xinyi Chen
- The School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China
| | - Xi Cao
- The School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China.
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Kumar R, Shaikh AH, Kumar A, Solangi BA, Naseer AB, Awan R, Chachar K, Talpur MFH, Saghir T, Sial JA, Qamar N, Karim M, Hakeem A. Age and gender-based categorization of very premature, premature, and non-premature acute myocardial infarction: A comparison of clinical and angiographic profile and in-hospital outcomes. Int J Cardiol 2023; 391:131292. [PMID: 37625483 DOI: 10.1016/j.ijcard.2023.131292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/27/2023] [Accepted: 08/20/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND In this study, we aimed to assess and compare the distribution of demographic and clinical characteristics and composite adverse clinical outcomes after primary percutaneous coronary intervention (PCI) among "very premature", "premature", and "non-premature" patients with "ST-segment elevation acute coronary syndrome (STE-ACS)" presented at a tertiary care center. METHODS We included consecutive patients diagnosed with STE-ACS undergoing primary PCI. The "very premature" was defined as ≤40 years for males and ≤ 45 years for females, "premature" as <55 years for males and < 65 years for females, and "non-premature" as ≥55 years for males and ≥ 65 years for females. Clinical characteristics, angiographic patterns, and hospital course were compared among the three groups. RESULTS In a sample of 4686 patients, 78.8%(3691) were male, and the average age was 55.6 ± 11 years. In total, 12%(561) were categorized as very premature, 38.3%(1797) as premature, and 49.7%(2328) as non-premature. The distribution of clinical characteristics in very premature, premature, and non-premature groups were as follows; hypertension in 44.6% vs. 53.5% vs. 54.9%; p < 0.001, diabetes in 30.3% vs. 36.8% vs. 35.5%; p = 0.018, smoking in 29.6% vs. 23.3% vs. 26.3%; p = 0.005, obesity in 19.4% vs. 18.4% vs. 15.3%; p = 0.008, single vessel diseases in 58.8% vs. 37.8% vs. 28.8%; p < 0.001, and composite adverse clinical outcomes in 14.1% vs. 16.7% vs. 21.8%; p < 0.001, respectively. CONCLUSION In conclusion, we have a substantial burden of premature STE-ACS. Very premature STE-ACS was found to be associated with a better prognosis, but a substantial burden of composite adverse clinical outcomes was also observed.
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Affiliation(s)
- Rajesh Kumar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
| | | | - Ashok Kumar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | | | - Ali Bin Naseer
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Romana Awan
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Kalsoom Chachar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | | | - Tahir Saghir
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Jawaid Akbar Sial
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Nadeem Qamar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Musa Karim
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - Abdul Hakeem
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
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Krittanawong C, Khawaja M, Tamis‐Holland JE, Girotra S, Rao SV. Acute Myocardial Infarction: Etiologies and Mimickers in Young Patients. J Am Heart Assoc 2023; 12:e029971. [PMID: 37724944 PMCID: PMC10547302 DOI: 10.1161/jaha.123.029971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Acute myocardial infarction is an important cause of death worldwide. While it often affects patients of older age, acute myocardial infarction is garnering more attention as a significant cause of morbidity and mortality among young patients (<45 years of age). More specifically, there is a focus on recognizing the unique etiologies for myocardial infarction in these younger patients as nonatherosclerotic etiologies occur more frequently in this population. As such, there is a potential for delayed and inaccurate diagnoses and treatments that can carry serious clinical implications. The understanding of acute myocardial infarction manifestations in young patients is evolving, but there remains a significant need for better strategies to rapidly diagnose, risk stratify, and manage such patients. This comprehensive review explores the various etiologies for acute myocardial infarction in young adults and outlines the approach to efficient diagnosis and management for these unique patient phenotypes.
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Affiliation(s)
| | - Muzamil Khawaja
- Cardiology DivisionEmory University School of MedicineAtlantaGAUSA
| | | | - Saket Girotra
- Division of Cardiovascular MedicineUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Sunil V. Rao
- New York University Langone Health SystemNew YorkNYUSA
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Topalkatti U, Chennamalla M, N R, B P, Banothu R. An In-Depth Prospective Comprehensive View on Myocardial Infarction (MI) in Young Adults. Cureus 2023; 15:e40630. [PMID: 37485181 PMCID: PMC10356967 DOI: 10.7759/cureus.40630] [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: 05/30/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Due to major advancements in myocardial infarction (MI) prevention and effective medical treatment, the death rate and incidence of MI have dropped considerably. We know that their risk factors and prognosis may differ; therefore, increasing primary and secondary prevention activities among young people is crucial. Multiple studies have found that MI is the deadliest form of coronary heart disease (CHD). As a result, we made an effort to illuminate MI in young people in our review of the literature. We found that young people, particularly women, are developing MI. Smoking is a key risk factor that should be targeted in an effort to minimize youth MI rates. It is thus important to create superior methods for measuring risk in young people, which may combine both standard and nonconventional risk factors, such as genetic rate scores and coronary artery calcium testing. Henceforth, addressing modifiable risk factors at a younger age has the greatest impact.
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Affiliation(s)
- Usha Topalkatti
- Internal Medicine, Spartan Health Sciences University School of Medicine, Vieux Fort, LCA
| | | | - Ramjoshna N
- Pulmonary Medicine, Mediciti Institute of Medical Sciences, Hyderabad, IND
| | - Paramesh B
- Internal Medicine, Mediciti Institute of Medical Sciences, Hyderabad, IND
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Alexim GDA, Rocha LF, Dobri GP, Rosa Júnior ADS, Reis RTB, Nogueira ACC, Soares AADSM, Sposito AC, de Paula AP, de Carvalho LSF. Clinical and economic impact of coronary artery bypass graft and percutaneous coronary intervention in young individuals with acute coronary syndromes and multivessel disease: A real-world comparison in a middle-income country. Front Cardiovasc Med 2022; 9:1000260. [PMID: 36440021 PMCID: PMC9685999 DOI: 10.3389/fcvm.2022.1000260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/17/2022] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND In recent decades, the world watched a dramatic increase in the incidence of acute coronary syndromes (ACS) among young individuals (≤55 years-old) and a relative decrease in the elderly. The management of ACS in young patients with multivessel disease still needs to be elucidated, as these individuals maintain a long life expectancy. RESEARCH QUESTION To compare clinical outcomes and care costs in individuals with premature ACS and multivessel disease undergoing coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). METHODS AND RESULTS Participants included all individuals ≤55 years-old admitted with ACS to public hospitals in Brasília (Brazil) between 2013 and 2015 and who underwent cardiac catheterization with SYNTAX score ≥23 or Duke category 6. Outcomes were adjudicated with death certificates and data from medical records. The primary outcome was the occurrence of major adverse cardiovascular events (MACE), defined as death due to cardiovascular causes, recurrent hospitalizations due to cardiovascular ischemic events, and incident heart failure New York Heart Association III-IV. As secondary outcome we assessed indirect and direct costs by evaluating the cost of lost productivity (in international dollars (Int$) per year) due to illness and death, outpatient costs and costs with new hospitalizations. Multivariate and principal components (PC) adjusted analyzes were performed. RESULTS Among 1,088 subjects (111 CABG and 977 PCI) followed for 6.2 years (IQR: 1.1), 304 primary events were observed. MACE was observed in 20.7% of the CABG group and 28.8% of the PCI group (p = 0.037). In multivariate analyses, PCI was associated with a hazard ratio (HR) = 1.227 (95% CI: 1.004-1.499; p = 0.0457) for MACE, and in PC-adjusted HR = 1.268 (95% CI: 1.048-1.548; p = 0.0271) compared with CABG. Despite direct costs were equivalent, the cost due to the loss of labor productivity was higher in the PCI group (Int$ 4,511 (IQR: 18,062)/year vs Int$ 3,578 (IQR: 13,198)/year; p = 0.049], compared with CABG. CONCLUSIONS Among young individuals with ACS and multivessel disease, surgical strategy was associated with a lower occurrence of MACE and lower indirect costs in the long-term.
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Affiliation(s)
- Gustavo de Almeida Alexim
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
| | - Luiza Ferreira Rocha
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Instituto de Cardiologia e Transplantes do Distrito Federal, Brasília, DF, Brazil
| | - Giovani Prediger Dobri
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Instituto de Cardiologia e Transplantes do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Ana Claudia Cavalcante Nogueira
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Aramari Apo Institute, Brasília, DF, Brazil
| | | | - Andrei Carvalho Sposito
- Aramari Apo Institute, Brasília, DF, Brazil
- Department of Cardiology, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ana Patricia de Paula
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
| | - Luiz Sérgio Fernandes de Carvalho
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Aramari Apo Institute, Brasília, DF, Brazil
- Laboratory of Data for Quality of Care and Outcomes Research, Clarity Healthcare Intelligence, Jundiaí, SP, Brazil
- Gerontology Post-Graduation Program, Universidade Católica de Brasília, Brasília, DF, Brazil
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