| BackgroundGenerally thinking,Coronary atherosclerosis heart disease(CHD)is a common disease in middle-aged and elderly.However,clinical observations find that coronary heart disease has a the youth oriented tendency.Especially patients with Acute myocardial infarction are very few in clinical study,such people are commonly urgenter,serious and even sudden death,which should arouse our attention.Therefore,it is necessary to strengthen the prevention work of causative factors and risk factors for the high-risk group of young patients with acute myocardial infarction,so as to delay the progress of the disease.ObjectiveBy comparing under the age of 26 out of coronary heart disease examination by coronary angiography with the age of 65 elderly patients with acute myocardial infarction in clinical characteristics and prognosis,analysis the causative factors,riskfactors in patients under the age of 26 with acute myocardial infarction,investigate the prognosis,search for the method of prevention of acute myocardial infarction and provides the basis for the primary prevention of coronary heart disease.MethodsBy the Case-control study,42 cases under the age of 26 with acute myocardial infarction was obtained from the first affiliated hospital of zhengzhou university center for medical record information system and remote consultation information as the experimental group,and at the same time choosing 60 cases of elderly with acute myocardial infarction as control,meanwhile,coronary angiography examination to rule out the coronary heart disease patients investigate the history of gender,family history,history of diabetes,hyperlipidemia,active smoking,passive smoking history(secondhand smoke),hypertension history,drinking history and other risk factors,analysis the triggers,coronary angiography and clinical characteristics,and carries on the comparison within-and inter-groups postoperative follow-up of 12 months,to observe the prognosis.Result(1)Cause: the experimental group had predisposing factors of staying up late,excessive fatigue,mental stress,lack of exercise and overeating prior to onset of illness compared with control group and the elderly group,differences has statistical significance(P < 0.05),the experimental group having the characteristic of emotional incentive prior to onset of illness has no statistical significance(P > 0.05)compared with the control group and the elderly group.(2)Risk factors: there were statistically significant differences in triglyceride levels,active smoking history,passive smoking history,drinking history between the experimental group and the control group or the elderly group(P<0.05).The sex ratio of patients in the experimental group was statistically significant(P<0.05).The proportion of hypertension patients in the experimental group was statisticallysignificant compared with the elderly group(P<0.05).The traditional risk factor diabetes was statistically significant between the experimental group and the old group(P<0.05),and the difference between the experimental group and the control group was not statistically significant(P <0.05).But there was no significant difference between the experimental group and the control group(P<0.05).(3)Clinical manifestations: the typical chest pain symptoms in the experimental group were significantly higher than that in the elderly group,with statistical differences(P<0.05).The symptoms of heart failure and prodrome were significantly lower than those in the elderly group(P<0.05).The difference in LVEF(left ventricular ejection fraction)was statistically significant between the experimental group and old age group(P<0.05),but there was no significant difference between the experimental group and the control group(P>0.05).The ECG types of the experimental group and the elderly group were mainly STEMI,with no significant difference(P>0.05),and there was no significant difference between the two groups in cardiac shock and arrhythmia(P>0.05).(4)CAG(Coronary angiography): there were more single lesions in the experimental group than the elderly group(P < 0.05),especially the former descending branch(LAD)showed great significance(P < 0.05),but less double branch lesions and multivessel lesions in the experimental group than the elderly group(P < 0.05).there was no significant difference in left main lesion,cyclotron lesions and the right Coronary artery lesions in the experimental group compared with the elderly group(P > 0.05),4 cases of Coronary angiography in the experimental group shown no significant stenosis in the experimental group compared with elderly group(P > 0.05).(5)Prognostic analysis: the two groups were follow-up and found that AMI nonfatal myocardial infarction and major cardiovascular events(MACE)are lower in the experimental group than the elderly group,difference has statistical significance(P < 0.05);There was no significant difference in oral antiplatelet drugs,ACEI/ARB,β receptor blockers and statins between two groups(P>0.05).Conclusion(1)The risk factors of patients with acute myocardial infarction(AMI)under the age of 25 are male,smoking(including smoking and inhalation "secondhand smoke"),dyslipidemia,drinking,have to stay up late,excessive fatigue,mental pressure and lack of exercise and other incentives.(2)There are few clinical precursive symptoms,often accompanied by sudden chest pain.The ECG is usually manifested as STEMI,and the cardiac function is generally normal.(3)The coronary angiography was mainly a single lesion,and the anterior descending branch was more affected,and the adverse cardiovascular events were less after the myocardial infarction,and the timely intervention and improvement of the life style had a good prognosis. |
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