Risk Factors And Characteristics Of Coronary Lesions In Patients With Acute Myocardial Infarction Under 45 Years Old

Objective:To investigate the risk factors,clinical features,characteristics of coronary artery lesions,complications,and mortality of young patients(aged below 45)with acute myocardial infarction in the elderly by comparing them with the characteristics of acute myocardial infarction in the elderly;For acute myocardial infarction,we strive to achieve early prevention,early diagnosis,and reasonable treatment.Methods:A retrospective analysis of cases was conducted.A total of young patients(age <45 years)with acute myocardial infarction diagnosed as having acute myocardial infarction and incomplete data were recruited consecutively between January 2015 and December 2017 at the Department of Cardiology,First People’s Hospital of Changde City.92 cases were observation group,including 88 males and 4 females,with an average age of 38.9±5.3 years.At the same time,103 elderly patients(age≥60 years)with acute myocardial infarction diagnosed in the same period and complete data were randomly selected as the control group.Including 61 males and 42 females,the average age was 68.1±5.8 years old.From the basic data of the observation group and the control group,the risk factors,predisposing factors,clinical characteristics,electrocardiogram,coronary lesion characteristics and complications,mortality and other aspects of comparison.Result:1.Compared with the elderly group,the incidence rate of male patients in the young group was higher than that of female patients(P<0.05).The smoking history,drinking history,family history of premature coronary heart disease were higher than that of the elderly group,and the drinking index and body mass index were similar.Higher than the older group(P <0.05);Youth group,triglyceride,total cholesterol,non-high-density lipoprotein cholesterol,uric acid,diastolic blood pressure and left ventricular ejection fraction,left ventricular short axis shortened score are higher than the elderly group(P<0.05);High-density lipoprotein cholesterol,homocysteine,fibrinogen,systolic blood pressure,and pulse pressure difference were lower in the elderly group(P<0.05),previous history of hypertension,diabetes history,and brain The history of vascular accidents and history of preinfarction angina was lower than that of the elderly group(P<0.05).2.Compared with the elderly group,67.4%(P<0.05)of the patients in the young group had a clear cause of morbidity,mainly fatigue and alcoholism,among which alcoholism was statistically significant(P<0.05);young people with acute ST elevation High-grade myocardial infarction was the main type(P<0.05).There was no statistically significant difference in the location of myocardial infarction in the electrocardiogram(P>0.05).Among the patients who had undergone coronary angiography,the single-vessel and localized lesions were more common in the younger group(P<0.05),4.7% of patients had no coronary artery stenosis;three-vessel disease,diffuse stenosis,and collateral circulation in the young group were lower than those in the elderly group(P<0.05);TIMC flow grading of the culprit vascular and offenders before vascular recanalization There was no significant difference between the two groups(P>0.05).3.Compared with the elderly group,the incidence of heart failure and arrhythmia in the young group was lower than that in the old group,and the mortality rate during the hospital stay was also lower than that in the old group(P<0.05);Conclusion:1.The incidence rate of male patients with acute myocardial infarction was significantly higher than that of women with smoking,alcohol consumption,weight,family history of premature coronary heart disease,elevated triglyceride,total cholesterol,non-high-density lipoprotein cholesterol,and uric acid levels.Lower levels of lipoprotein cholesterol,fibrinogen,and homocysteine are the main features.2.Compared with the elderly group,the incidence of acute myocardial infarction in the youth group was mainly caused by exertion and alcoholism.There was no recurrent angina attack before myocardial infarction.3.Acute myocardial infarction in young patients is mainly acute ST-segment elevation myocardial infarction,with little collateral circulation formation,and the culprit vessels are often single,localized lesions are more common,left main artery is less involved,heart function is available,and complications are few.The mortality rate during hospitalization is low.