Clinical Characteristics And Coronary Artery Lesions Of Acute ST-Segment Elevation Myocardial Infarction In Young Adults

Objective: To analyze the risk factors,clinical characteristics and coronary artery lesions of acute ST-segment elevation myocardial infarction in young adults.The information about these may have an influence on the strategies for prevention,diagnosis and management for acute ST-segment elevation myocardial infarction in young adults.Methods: Random sampling to choose 188 cases of patients with acute ST-segment elevation myocardial infarction in our hospital emergency line coronary artery angiography diagnosis in April 2014-March 2016.18 to44-year-old person with acute myocardial infarction is defined as youth group.45 to 74-year-old person with acute myocardial infarction is defined as elderly group.Youth group has 104 cases.Elderly group has 84 cases.To discuss risk factors,incentive,clinical characteristics,coronary angiographic findings,the position of myocardial infarction,killip classification between the youth group and elderly group.In this study,some patients of this group don’t have an operation of emergency PCI.Main causes include too long time to hospital from onset time,bleeding,not been ruled out early diagnosis,disagreement with patients.Creating a database through the application of SPSS 19.0software package for statistical analysis.The measurement data were expressed as mean ± standard deviation((?)±s).The count data were expressed as rate.P<0.05 was considered statistically significant.Results: 1 In this study,188 cases of patients with acute ST-segment elevation myocardial infarction,94 men in youth group(90.4% of the total number of youth group)and 66 men in elderly group(78.6% of the total number of elderly group).The proportion of male in youth group is higher than the elderly group(P < 0.05).84 patients with smoking history in youth group(80.8% of the total number of youth group)and 52 patients in elderly group(61.9% of the total number of elderly group).The proportion of smoking history in youth group is higher than the elderly group(P < 0.05).18 patients with family history of early onset coronary artery disease in youth group(17.3% of the total number of youth group)and 4 patients in elderly group(4.8% of the total number of elderly group).The proportion of family history of early onset coronary artery disease in youth group is higher than the elderly group(P < 0.05).30 patients with history of hypertension in youth group(28.8% of the total number of youth group)and 42 patients in elderly group(50% of the total number of elderly group).The proportion of history of hypertension in youth group is lower than the elderly group(P < 0.05).12 patients with type 2 diabetes in youth group(11.5% of the total number of youth group)and 28 patients in elderly group(33.3% of the total number of elderly group).The proportion of type 2 diabetes in youth group is lower than the elderly group(P < 0.05).BMI in youth group is 27.89±1.92,BMI in elderly group is 23.79±3.52,BMI in youth group is higher than the elderly group(P < 0.05).25 patients with extensive anterior wall myocardial infarction in youth group(24.0% of the total number of youth group)and 6patients in elderly group(7.1% of the total number of elderly group).The proportion of extensive anterior wall myocardial infarction in youth group is higher than the elderly group(P < 0.05).75 patients with KillipⅠ in youth group(72.1% of the total number of youth group)and 44 patients in elderly group(52.4% of the total number of elderly group),1 patient with Killip Ⅳin youth group(1% of the total number of youth group)and 10 patients in elderly group(11.9% of the total number of elderly group),in youth group,KillipⅠis higher than the elderly group,with significant difference(P < 0.05),Killip Ⅳ is lower than the elderly group,with significant difference(P <0.05).Analyze the number of risk factor including men,smoking history,drinking,family history of early onset coronary artery disease,hypertension,type 2 diabetes,25 patients with one risk factor in youth group(21.6% of the total number of youth group)and 12 patients in elderly group(14.3% of the total number of elderly group),14 patients with three risk factors in youthgroup(12.1% of the total number of youth group)and 22 patients in elderly group(26.2% of the total number of elderly group).In youth group,one risk factor is higher than the elderly group,with significant difference(P < 0.05),three risk factors is lower than the elderly group with significant difference(P< 0.05).Systolic pressure on admission in youth group is 121.48±19.26 mmHg,systolic pressure on admission in elderly group is 132.48±29.62 mmHg,systolic pressure in youth group is lower than the elderly group(P < 0.05).Diastolic pressure and heart rate on admission in two groups have no significant difference(P>0.05).Dinking in two groups has no significant difference(P>0.05).2 Comparison of biochemical indicators,compare with youth group and elderly group,LDL-C are 2.97±1.24mmol/L and 2.53±0.95mmol/L(P<0.05),TC are 4.69±1.54mmol/L and 3.95±0.90mmol/L(P<0.05),TG are4.54±1.40mmol/L and 1.86±0.74mmol/L(P<0.05).In youth group,TC,TG,LDL-C are higher than elderly group with significant difference.Fasting blood-glucose in youth group is 6.52±2.99mmol/L,fasting blood-glucose in elderly group is 7.68±3.54mmol/L,fasting blood-glucose in youth group is lower than the elderly group(P < 0.05).HDL-C,homocysteine,c-reactive protein,uric acid in two groups have no significant difference(P>0.05).3 From the results of coronary angiographic,91 patients with anterior descending artery lesion in youth group(87.9% of the total number of youth group)and 74 patients in elderly group(88.1% of the total number of elderly group).50 patients with LCX lesion in youth group(48.1% of the total number of youth group)and 60 patients in elderly group(71.4% of the total number of elderly group).56 patients with RCA lesion in youth group(53.8% of the total number of youth group)and 64 patients in elderly group(76.2% of the total number of elderly group).2 patients with LM lesion in youth group(1.9% of the total number of youth group)and 8 patients in elderly group(9.5% of the total number of elderly group).39 patients with single-vessel lesion in youth group(37.5% of the total number of youth group)and 12 patients in elderly group(14.3% of the total number of elderlygroup).32 patients with double-vessel lesion in youth group(30.8% of the total number of youth group)and 30 patients in elderly group(35.7% of the total number of elderly group).33 patients with triple-vessel lesion in youth group(31.7% of the total number of youth group)and 42 patients in elderly group(50% of the total number of elderly group).42 patients with totally occluded lesion in youth group(40.4% of the total number of youth group)and 18 patients in elderly group(21.4% of the total number of elderly group).56 patients with thrombus in youth group(53.8% of the total number of youth group)and 21 patients in elderly group(25% of the total number of elderly group).14 patients with collateral circulation in youth group(13.5%of the total number of youth group)and 20 patients in elderly group(23.8%of the total number of elderly group).9 patients with diffuse lesion in youth group(8.7% of the total number of youth group)and 22 patients in elderly group(26.2% of the total number of elderly group).In elderly group,LCX,RCA,LM,collateral circulation,triple-vessel disease are more easier involved than the youth group,with significant difference(P<0.05).Single-vessel lesion,thrombus and totally occluded lesion in the youth group are significantly higher than the elderly group.Compared with these two groups,double-vessel lesion has no significant difference(P > 0.05).Compare with youth group and elderly group,the time of coronary angiography from myocardial infarction are 2.40±2.77 and 4.21±2.64,the time of coronary angiography from myocardial infarction has significant difference(P<0.05).24 patients with emergency PCI in youth group(26.0%of the total number of youth group)and 4 patients in elderly group(4.8% of the total number of elderly group),the number of emergency PCI patients have significant difference(P<0.05).Compared with these two groups,the criminal vascular and the proportion of thrombolytic therapy have no significant difference(P>0.05).4 Prognostic indicators,Ejection fraction in youth group is 56.28 ±6.28%,ejection fraction in elderly group is 49.56±14.26%,ejection fraction in youth group is higher than elderly group(P<0.05).1 patient in youth groupdead in hospital,8 patients in elderly group dead in hospital,in youth group,in-hospital mortality is lower than the elderly group,with significant difference(P < 0.05).Conclusions:1 Man,smoking and family history of early onset coronary artery disease are common with young acute ST-segment elevation myocardial infarction adults.2 The proportion of single-vessel lesion,thrombus,totally occluded lesion with young acute ST-segment elevation myocardial infarction patients is high.3 The young acute ST-segment elevation myocardial infarction patients have low mortality.