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Original Research

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Clinical and paraclinical characteristics of young patients with myocardial infarction from Northeast of Romania

  • Andrei-Nicolae Ceobanu1
  • Larisa Anghel2,3,*,
  • Radu Sascău2,3,*,
  • Iulian-Dan Cuciureanu1,2
  • Constantin-Bogdan Monac1
  • Alexandru-Florin Braniște4
  • Răzvan Achiței5
  • Cristian Stătescu2,3

1Neurology Department, Emergency University Hospital “Prof. Dr. N. Oblu”, 700112 Iasi, Romania

2Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania

3Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I.M.Georgescu”, 700503 Iasi, Romania

4Endocrinology Department, Emergency University Hospital "Sf. Spiridon", 700111 Iasi, Romania

5Anaesthiology and Intensive Care department, Regional Institute of Oncology, 700483 Iasi, Romania

DOI: 10.22514/sv.2021.255 Vol.18,Issue 5,September 2022 pp.95-102

Submitted: 16 September 2021 Accepted: 16 November 2021

Published: 08 September 2022

*Corresponding Author(s): Larisa Anghel E-mail: larisa.anghel@umfiasi.ro
*Corresponding Author(s): Radu Sascău E-mail: radu.sascau@gmail.com

Abstract

The aim of this study was to evaluate the clinical and paraclinical features in young patients (18–40 years) with acute myocardial infarction (AMI) in the Northeast of Romania. We have considered all patients admitted between the 1st of January 2017 through the 31st of December 2019 at a tertiary care Cardiology Institute with the primary discharge diagnosis of AMI. These patients have been split into 2 groups depending on their age: the first group consisting of patients with an age equal to or lower than 40 years old and the second group consisting of patients with an age greater than 40 years old. After this, we have randomly selected a representative sample from each of the two groups. A total of 99 patients were ultimately enrolled in the study: 42 in the first group and 57 in the second group. Data collected included age, gender, medical history, laboratory tests, echocardiography parameters, coronarography study results, and case outcome. Most young patients with myocardial infarction were male, more likely to smoke (69% vs 35.1%, p = 0.001), and with a positive family history of cardiovascular diseases (35.7% vs 1.8%, p < 0.001) in comparison to their older counterparts. Also, they had fewer comorbidities, such as diabetes mellitus, hypertension, or a positive history of stroke or atrial fibrillation. Mean ejection fraction was significantly higher in young patients (43.4 ± 10.65 vs 37.16 ± 10.77, p = 0.005) and both tricuspid and mitral valve regurgitations were less severe. Coronary lesions were more severe in the older patients (p = 0.009), usually with more coronary arteries involved. No significant difference was recorded in the number of hospitalization days or in the case outcome. Acute myocardial infarction in young patients typically occurs more in men who smoke, those who are more than 30 years old, and those who have a positive family history of cardiovascular diseases. Echocardiographic parameters seem to be better than in the case of older patients and the coronary involvement is usually less severe.


Keywords

Myocardial infarction; Young adults; Cardiovascular risk factors; Mortality


Cite and Share

Andrei-Nicolae Ceobanu,Larisa Anghel,Radu Sascău,Iulian-Dan Cuciureanu,Constantin-Bogdan Monac,Alexandru-Florin Braniște,Răzvan Achiței,Cristian Stătescu. Clinical and paraclinical characteristics of young patients with myocardial infarction from Northeast of Romania. Signa Vitae. 2022. 18(5);95-102.

References

[1] Hay SI, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017; 390: 1260–1344.

[2] Yazdanyar A, Newman AB. The Burden of Cardiovascular Disease in the Elderly: Morbidity, Mortality, and Costs. Clinics in Geriatric Medicine. 2009; 25: 563–577.

[3] North BJ, Sinclair DA. The Intersection between Aging and Cardiovas-cular Disease. Circulation Research. 2012; 110: 1097–1108.

[4] Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, et al. Cardiovascular Risks Associated with Gender and Aging. Journal of Cardiovascular Development and Disease. 2019; 6: 19.

[5] Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults. Postgraduate Medical Journal. 2005; 81: 741–745.

[6] Bhardwaj R, Kandoria A, Sharma R. Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement. Nigerian Medical Journal. 2014; 55: 44.

[7] Gulati R, Behfar A, Narula J, Kanwar A, Lerman A, Cooper L, et al. Acute Myocardial Infarction in Young Individuals. Mayo Clinic Proceedings. 2020; 95: 136–156.

[8] Ge J, Li J, Yu H, An Y. Acute myocardial infarction in young adults: Risk factors, clinical features, and management strategies. Cardiology Plus. 2017; 2: 21.

[9] Jing M, Gao F, Chen Q, de Carvalho LP, Sim L, Koh T, et al. Comparison of Long-Term Mortality of Patients Aged ≤40 Versus >40 Years with Acute Myocardial Infarction. The American Journal of Cardiology. 2016; 118: 319–325.

[10] Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, Danaei G. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. The Lancet. 2014; 383: 970–983.

[11] Kanitz MG, Giovannucci SJ, Jones JS, Mott M. Myocardial infarction in young adults: Risk factors and clinical features. The Journal of Emergency Medicine. 1996; 14: 139–145.

[12] Tsai WC, Wu KY, Lin GM, Chen SJ, Lin WS, Yang SP, et al. Clinical characteristics of patients less than forty years old with coronary artery disease in Taiwan: A cross-sectional study. Acta Cardiologica Sinica. 2017; 33: 233–240.

[13] Maas AHEM, Appelman YEA. Gender differences in coronary heart disease. Netherlands Heart Journal. 2010; 18: 598–603.

[14] Iorga A, Cunningham CM, Moazeni S, Ruffenach G, Umar S, Eghbali M. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biology of Sex Differences. 2017; 8: 33.

[15] Giordano S, Hage FG, Xing D, Chen YF, Allon S, Chen C, et al. Estrogen and Cardiovascular Disease: is Timing everything? The American Journal of the Medical Sciences. 2015; 350: 27–35.

[16] Gina PL, Nanette KW. Menopause Hormone Therapy: What a Cardiologist Needs to Know-American College of Cardiology. 2021. Available at: https://www.acc.org/latest-in-cardiology/articles/ 2019/07/17/11/56/menopause-hormone-therapy (Accessed: 31 July 2021).

[17] Sinha SK, Krishna V, Thakur R, Kumar A, Mishra V, Jha MJ, et al. Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in north India-AMIYA study. ARYA Atherosclerosis. 2017; 13: 79–87.

[18] Arvind P, Nair J, Jambunathan S, Kakkar VV, Shanker J. CELSR2–PSRC1–SORT1 gene expression and association with coronary artery disease and plasma lipid levels in an Asian Indian cohort. Journal of Cardiology. 2014; 64: 339–346.

[19] Kyto V, Sipila J, Rautava P. Acute myocardial infarction or acute myocarditis? Discharge registry-based study of likelihood and associated features in hospitalised patients. BMJ Open. 2015; 5: e007555.

[20] Ängerud KH, Thylén I, Sederholm Lawesson S, Eliasson M, Näslund U, Brulin C. Symptoms and delay times during myocardial infarction in 694 patients with and without diabetes; an explorative cross-sectional study. BMC Cardiovascular Disorders. 2016; 16: 108.

[21] Lei L, Bin Z. Risk Factor Differences in Acute Myocardial Infarction between Young and Older People: A Systematic Review and Meta-Analysis. International Journal of Cardiovascular Sciences. 2019; 32: 163–176.

[22] Popa S, Mota M, Popa A, Mota E, Timar R, Serafinceanu C, et al. Prevalence of dyslipidemia and its association with cardiometabolic factors and kidney function in the adult Romanian population: the PREDATORR study. Diabetes & Metabolic Syndrome. 2019; 13: 596–602.

[23] Carreras G, Pistelli F, Falcone F, Carrozzi L, Martini A, Viegi G, et al. Reduction of Risk of Dying from Tobacco-related Diseases after Quitting Smoking in Italy. Tumori Journal. 2015; 101: 657–663.

[24] Ranthe MF, Petersen JA, Bundgaard H, Wohlfahrt J, Melbye M, Boyd HA. A Detailed Family History of Myocardial Infarction and Risk of Myocardial Infarction – A Nationwide Cohort Study. PLoS ONE. 2015; 10: e0125896.

[25] Ambroziak M, Niewczas-Wieprzowska K, Maicka A, Budaj A. Younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature atherosclerosis. BMC Cardiovascular Disorders. 2020; 20: 410.

[26] Shah N, Wang C, Lee V, Cox N, Wong C, Kelly AM. Myocardial Infarction in Young versus Older Adults: An Analysis of Differences in Proportion, Risk Factors, Clinical Demographics, Angiographic Findings and in-Hospital Outcomes. International Journal of Cardiology. 2016; 3: 79.

[27] Obaya M, Yehia M, Hamed L, Fattah AA. Comparative study between elderly and younger patients with acute coronary syndrome. The Egyptian Journal of Critical Care Medicine. 2015; 3: 69–75.

[28] Bhardwaj R, Kandoria A, Sharma R. Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement. Nigerian Medical Journal. 2014; 55: 44.

[29] Goodnough LT, Schrier SL. Evaluation and management of anemia in the elderly. American Journal of Hematology. 2014; 89: 88–96.

[30] Ruan Y, Guo Y, Kowal P, Lu Y, Liu C, Sun S, et al. Association between anaemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China. BMC Geriatrics. 2019; 19: 327.

[31] Stauder R, Valent P, Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018; 131: 505–514.

[32] Feig DI, Kang DH, Johnson RJ. Uric Acid and Cardiovascular Risk. New England Journal of Medicine. 2008; 359: 1811–1821.

[33] Muiesan ML, Agabiti-Rosei C, Paini A, Salvetti M. Uric Acid and Cardiovascular Disease: an Update. European Cardiology Review. 2016; 11: 54.

[34] Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care & Research. 2011; 63: 102–110.

[35] Chouhan L, Hajar HA, Pomposiello JC. Comparison of thrombolytic therapy for acute myocardial infarction in patients aged <35 and >55 years. The American Journal of Cardiology. 1993; 71: 157–159.

[36] Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults. Postgraduate Medical Journal. 2005; 81: 741–745.

[37] Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JA, et al. Presentation, Clinical Profile, and Prognosis of Young Patients with Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): Results from the VIRGO Study. Journal of the American Heart Association. 2018; 7: e009174.

[38] Abdu FA, Mohammed AQ, Liu L, Xu Y, Che W. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): a Review of the Current Position. Cardiology. 2020; 145: 543–552.

[39] Kang WY, Jeong MH, Ahn YK, Kim JH, Chae SC, Kim YJ, et al. Are patients with angiographically near-normal coronary arteries who present as acute myocardial infarction actually safe? International Journal of Cardiology. 2011; 146: 207–212.

[40] Woon VC, Lim KH. Acute myocardial infarction in the elderly–the differences compared with the young. Singapore Medical Journal. 2003; 44: 414–418.

[41] Morillas PJ, Cabadés A, Bertomeu V, Echanove I, Colomina F, Cebrián J, et al. Acute myocardial infarction in patients under 45 years. Revista Espanola de Cardiologia. 2002; 55: 1124–1131.



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