| ObjectiveTo explore the influencing factors of acute myocardial infarction(AMI)in young and middle-aged patients with family history of coronary heart disease,and to provide evidence for the prevention of AMI.MethodFrom December 2006 to June 2014,12556 patients with coronary heart disease(CHD)underwent percutaneous coronary intervention(PCI)in our hospital were collected.A total of 513 patients with family history of CHD and less than 60 years old were screened out.Baseline data(including gender,age,body mass index,BMI)and general risk factors for CHD(including smoking,alcohol consumption,diabetes,hypertension and hyperlipidemia)were collected.Patients diagnosed as AMI and undergoing PCI(199 cases)as case group,patients diagnosed as non-AMI and undergoing PCI(314 cases)as control group.SPSS19.0 statistical software was used for statistical analysis.Variables whose measurements conform to normal distribution are expressed by mean±standard deviation)(x±s).T-test was used for comparison between groups,and rate(%)was used for counting data.Chi-square test or Fisher exact probability test were used for comparison among groups.Logistic regression model was used to analyze the risk factors of young and middle-aged AMI patients with CHD family history,P<0.05 is the difference with statistical significance.ResultThe comparison between the two groups showed that the percentage of smoking history in the case group was significantly higher than that in the control group(85.4% vs 63.7%,P=0.001).Age,history of hyperlipidemia and hypertension in the case group were significantly lower than those in the control group(51.80 + 5.82 vs 55.02 + 4.03,P=0.020;42.7% vs 55.4%,P=0.022 and 54.8% vs 63.4%,P=0.046,respectively),The differences were statistically significant.In the age group less than 50 years old(n=148),age-based subgroup analysis showed that the percentage of smokers had significant difference between the two groups(90.5% vs 68.9%,P=0.005).There were no significant differences in gender,diabetes,hyperlipidemia,alcohol consumption,hypertension and BMI between pathological group and control group(97.3% vs 91.9%,P=0.877;25.7% vs 44.6%,P=0.059;39.2% vs 58.1%,P=0.119;58.1% vs 54.1%,P=0.968;54.1% vs 54.1%,P=0.461;26.92+4.57 vs 26.33+3.92,P=0.479).In the 50-59 age group(n=365),there were significant differences in the percentage of smoking and drinking between the two groups(82.4% vs 62.1%,P=0.041 and 59.2% vs 37.9%,P=0.018).The percentage of hypertension in the case group was significantly lower than that in the control group(52.8% vs 66.2%,P = 0.009).There was no significant difference in gender,hyperlipidemia,diabetes mellitus and BMI between the two groups(88.8% vs 73.3%,P=0.318;44.8% vs 54.6%,P=0.149;29.6% vs 33.8%,P=0.786;27.13+4.57 vs 26.76+3.97,P=0.217).ConclusionSmoking is an important risk factor for young and middle-aged AMI patients with family history of CHD diagnosed by imaging.Hypertension,diabetes mellitus,hyperlipidemia,age,alcohol consumption and BMI are important risk factors for CHD,but they do not increase the incidence of first AMI in young and middle-aged adults with positive family history of CHD.In the age subgroup,the distribution of risk factors was similar. |
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