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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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Gao J, Yang YN, Cui Z, Feng SY, Ma J, Li CP, Liu Y. Pcsk9 is associated with severity of coronary artery lesions in male patients with premature myocardial infarction. Lipids Health Dis 2021; 20:56. [PMID: 34044829 PMCID: PMC8161665 DOI: 10.1186/s12944-021-01478-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Proprotein convertase subtilisin/kexin type 9 (Pcsk9) correlated with incidence and prognosis of coronary heart disease. However, it is unclear whether Pcsk9 contributed to coronary artery lesion severity in patients with premature myocardial infarction (PMI). The present study investigated associations between Pcsk9 and coronary artery lesion severity in PMI patients who underwent coronary angiography (CAG). METHODS This prospective cohort study included young men (age ≤ 45 years, n = 332) with acute MI who underwent CAG between January 2017 and July 2019. Serum Pcsk9 levels and clinical characteristics were evaluated. SYNTAX scores (SYNergy between percutaneous coronary intervention with [paclitaxel-eluting] TAXUS stent and cardiac surgery) were calculated to quantify coronary artery lesions. RESULTS Serum Pcsk9 levels were positively associated with SYNTAX scores (r = 0.173, P < 0.05). The diagnostic cutoff value of PSCK9 level was 122.9 ng/mL, yielding an area under the curve (AUC) of 0.63, sensitivity 81%, and specificity 40%. Serum Pcsk9, LDL-C, Apob, NT-proBnp, CK level, and diabetes history were independent predictors of high SYNTAX scores (P < 0.05). After stratifying by serum LDL-C level (cutoff = 2.6 mmol/L), medium-high Pcsk9 levels had increased risk of high SYNTAX scores in patients with high LDL-C (P < 0.05), and higher serum Pcsk9 levels had increased risk of major adverse cardiac events (MACE) after adjusting for confounding factors (P < 0.05). CONCLUSION Serum Pcsk9 levels correlates with severity of coronary artery lesion in PMI patients and may serve as a biomarker for severity of coronary artery stenosis in this patient population, which may contribute to risk stratification.
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Affiliation(s)
- Jing Gao
- Chest Hospital, Tianjin University, No.92 Weijin Road Nankai District, Tianjin, 300072, P.R. China
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi xiang tai Road, Heping District, Tianjin, 300070, P.R. China
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China
| | - Ya-Nan Yang
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Zhuang Cui
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Si-Yuan Feng
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China
| | - Jing Ma
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China
| | - Chang-Ping Li
- Tianjin Medical University, No.22 Qi xiangtai Road, Heping District, Tianjin, 300070, P.R. China.
| | - Yin Liu
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi xiang tai Road, Heping District, Tianjin, 300070, P.R. China.
- Department of Cardiology, Tianjin Chest Hospital, No.261 Tai erzhuang Road, Jinnan District, Tianjin, 300222, P.R. China.
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Obeidat OS, Makhamreh H, Al-Muhaisen RZ, Obeidat LR, Kitana FI, Amarin JZ, Ebada MA, Murad MA, Alhameedi T, Haj-Yasin D, Hammoudeh A. Clinical Characteristics and Prognosis of Young Middle Eastern Adults with ST-Elevation Myocardial Infarction: One-Year Follow-Up. Heart Views 2021; 22:88-95. [PMID: 34584618 PMCID: PMC8445134 DOI: 10.4103/heartviews.heartviews_67_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI. METHODS AND MATERIAL A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated. RESULTS Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036). CONCLUSIONS Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.
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Affiliation(s)
- Omar Sami Obeidat
- Department of Internal Medicine, The University of Jordan, Amman, Jordan
| | - Hanna Makhamreh
- Department of Internal Medicine, The University of Jordan, Amman, Jordan
| | | | | | | | | | | | - Mhd Anas Murad
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Tuqa Alhameedi
- School of Medicine, The University of Jordan, Amman, Jordan
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Cannabis and tramadol addiction: Do they imply additive risk for acute myocardial infarction in adults younger than 45 years? Anatol J Cardiol 2020; 24:316-325. [PMID: 33122481 PMCID: PMC7724384 DOI: 10.14744/anatoljcardiol.2020.67206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Acute myocardial infarction (AMI) is the main cause of cardiovascular events worldwide. AMI commonly occurs in elderly patients because of atherosclerotic process related to common risk factors. Consequently, the rupture of atheromatous plaque with deleterious sequela is the common etiology of the disease. However, there are less studied etiological factors in youth compared with the usual population. Therefore, this study aimed to examine the risk profile of Egyptian youth presenting with AMI. METHODS A study was conducted in 106 patients aged ≤45 years admitted with AMI in our university hospital to explore their clinical profile risk factors. RESULTS In the study, 71 (67%) and 35 (33%) patients presented with ST elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Anterior wall MI was predominant in 49 patients (46.2%). Moreover, 93 patients (88%) were smokers, 31 (29.2%) used tramadol, 43 (40.6%) smoked cannabis, 50 (47.2%) had poor sleeping habits, 29 (27.4%) had high stress levels, 37 (34.9%) had hypertension, and 22 (20.8%) had diabetes. Twenty (18.9%) patients had a family history of premature coronary artery disease. High and low high-density lipoprotein (HDL) levels were observed in 20 (18.9%) and 47 (44.3%) patients, respectively. The left anterior descending artery (LAD) was involved in 56% of the studied population associated with tramadol use. A significant association was found between both tramadol use and cannabis smoking and presence of heavy thrombus burden on coronary angiography. CONCLUSION AMI in Egyptian youth was predominantly observed in men, with anterior STEMI as the most common presentation. Cannabis and tramadol addiction were high risk factors for AMI in Egyptian youth.
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Caimi G, Montana M, Andolina G, Hopps E, Lo Presti R. Plasma Viscosity and NLR in Young Subjects with Myocardial Infarction: Evaluation at the Initial Stage and at 3 and 12 Months. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2019; 13:1179546819849428. [PMID: 31205431 PMCID: PMC6535909 DOI: 10.1177/1179546819849428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 04/01/2019] [Indexed: 11/15/2022]
Abstract
In the "Sicilian study on juvenile myocardial infarction," we had evaluated plasma viscosity (PV) and neutrophil/lymphocyte ratio (NLR) in patients with acute myocardial infarction (AMI) at the age of ⩽45 years. Now, we examined the relationship between these 2 parameters in 120 subjects (109 men and 11 women) aged ⩽45 years with recent AMI. The patients were classified according to the number of cardiovascular risk factors, the electrocardiographic criteria (ST-segment elevation myocardial infarction [STEMI] or non-ST-segment elevation myocardial infarction [NSTEMI]), and the extent of coronary stenosis, evaluated with coronary angiography. On fasting venous blood, we measured PV at the shear rate of 450 s-1 and NLR. The control group included 50 healthy subjects (mean age = 35.1 ± 7.8 years). At the initial stage, PV and NLR were significantly increased in comparison with controls. Subdividing AMI patients according to the median value of NLR, in the group with high NLR PV was significantly higher, whereas subdividing the patients according to the PV median value, NLR was not different between the 2 groups; 3 and 12 months after AMI, we observed only a significant decrease in NLR. Only PV was discriminant regarding the cardiovascular complications registered during an 18-month follow-up. The evaluation of PV may be of prognostic value in juvenile AMI.
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Affiliation(s)
- Gregorio Caimi
- Gregorio Caimi, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Via del Vespro, 129 90127 Palermo, Italy.
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Qian G, Zhou Y, Liu HB, Chen YD. Clinical Profile and Long-Term Prognostic Factors of a Young Chinese Han Population (≤ 40 Years) Having ST-Segment Elevation Myocardial Infarction. ACTA CARDIOLOGICA SINICA 2016; 31:390-7. [PMID: 27122898 DOI: 10.6515/acs20140929d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The proportion of the mainland Chinese population with premature ST-segment elevation myocardial infarction is significantly elevated. Young patients with ST-segment elevation myocardial infarction have a different risk factor profile and clinical outcome compared with elder patients, and may also differ as compared to young patients in Western populations. METHODS We analyzed a total of 9462 consecutive ST-segment elevation myocardial infarction patients, and recruited 341 consecutive cases who had survived their first ST-segment elevation myocardial infarction at the age less than 40 years, and followed-up these patients for 5 years. RESULTS The most prevalent risk factor in young Chinese ST-segment elevation myocardial infarction patients was smoking (307/341, 90.03%) and male gender (328/341, 96.19%), although young patients had fewer traditional risk factors of acute myocardial infarction than the control group [(1.63 ± 1.03) vs. (2.38 ± 1.15), p < 0.01]. The number of affected vessels in cases was significantly less than in the elder control group (p < 0.01). During the follow-up, blood lipids and blood pressure of most patients reached the target level, while 42.10% of patients reported continuation of smoking. Multivariable data analysis showed that persistence of smoking (OR: 3.784, 95% CI: 1.636-8.751, p < 0.01) was the most significant prognostic factor of cardiac events after adjusting for various confounding factors. CONCLUSIONS We demonstrated that cigarette smoking is the most prevalent factor among the avoidable cardiovascular risk factors for young ST-segment elevation myocardial infarctions in China. Accordingly, continued smoking is the most powerful predictor for the recurrence of cardiac events in young Chinese patients with ST-segment elevation myocardial infarction. KEY WORDS Premature myocardial infarction; Prognosis; Risk factor.
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Affiliation(s)
- Geng Qian
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ying Zhou
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Hong-Bin Liu
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yun-Dai Chen
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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