| Objective:Age is an important uncontrollable risk factor for acute myocardial infarction(AMI).Cardiovascular risk factors(CVRFs)and severity of coronary artery disease are different in all age groups of acute myocardial infarction.At present,the onset age of acute myocardial infarction in China is younger and older,this study mainly analyzed and compared the risk factors and characteristics of coronary artery lesions between young and middle-aged patients with acute myocardial infarction,providing a scientific basis for screening high-risk groups,diagnosis,treatment and prognosis of AMI.Methods:A retrospective study was conducted to investigate 226 patients with AMI admitted to the Department of Cardiology,First Hospital of Shanxi Medical University from January 2017 to October 2018.The clinical data were collected and divided into two groups according to the age of patients: young-middle-aged group(<60years old)(106 cases)and old group(≥ 60 years old)(120 cases).The risk factors,clinical characteristics and severity of coronary artery disease were analyzed and compared between the two groups.Results:1.There are 96.9% of AMI patients had one intervening CVRFs.The rates of hypertension,hyperlipidemia and diabetes in AMI patients were 53.5%,54.4% and 36.3%.The proportion of smokers was 53.1%,4.9% had a family history of premature coronary heart disease,and 56.6% were overweight or obese.2.The proportion of male AMI patients(90.6% VS 65.8%),smoking history(62.3% VS 45.0%),overweight/obesity(67.0% VS 47.5%)in the young and middle-aged group were higher than that in the elderly group.The prevalence of hypertension(62.5% VS 43.4%)and diabetes(42.5% VS 29.2%)in the elderly group was significantly higher than that in the young and middle-aged group.(P < 0.05).Logistic regression analysis showed that smoking,overweight/obesity,high triglyceride and low high-density lipoprotein cholesterol were independent risk factors for AMI in young and middle-aged people.3.The prevalence of hyperlipidemia(62.5% VS 46.8%),overweight/obesity(66.7% VS 46.8%)and hypertension(43.8% VS 69.6%)were higher in the young and middle-aged male group than in the elderly male group.(P < 0.05).There was no difference in CVRFs between young-middle-aged female group and elderly female group.4.The proportion of AMI patients with preexisting inducement in the young and middle-aged group was higher than that in the old group(39.6% VS 25.0%)(P < 0.05).The incidence of chest pain in the young and middle-aged group was higher than that in the old group(84.9% vs.68.3%),while the incidence of other symptoms(such as upper abdominal pain,back pain,nausea,vomiting,sweating,palpitations,etc.)was lower than that in the old group(8.5% vs.17.7%)(P < 0.05).There was no difference in the proportion of symptoms of cardiac insufficiency mainly manifested as dyspnea,fatigue and fatigue between the two groups(P > 0.05).5.Pulse pressure in elderly patients with AMI was higher than that in young and middle-aged patients [(63.34±91.95)mmHg VS(42.75±14.97)mmHg].In elderly patients,B-type natriuretic peptide precursor [(3733.17±6212.90)ng/L VS(1274.27±1451.23)ng/L],left ventricular end-diastolic diameter [(52.75±5.52)mm VS(50.26±6.39)mm] were higher than that in young and middle-aged patients.The level of triglyceride in young and middle-aged patients with AMI was higher than that in old patients [(1.90±0.90)mmol/L VS(1.57±0.63)mmol/L],and HDL cholesterol was lower than that in old patients [(0.95±0.24)mmol/L VS(1.06±0.29)mmol/L].The proportion of ST-segment elevation myocardial infarction in young and middle-aged group was higher than that in old group(77.36% VS 64.17%).(P < 0.05).6.The proportion of single vessel lesions in the young and middle-aged group was higher than that in the old group(47.2% VS 29.2%),and the proportion of three vessel lesions was lower than that in the old group(7.5% VS 20%).Conclusion:1.AMI patients are often associated with multiple CVRFs.CVRFs were different among AMI patients of different age groups.The proportion of overweight/obesity among AMI patients in the young and middle-aged group was higher than that in the elderly group,which was mainly caused by unhealthy living habits.Life intervention and drug treatment were of great significance in preventing or delaying the occurrence of AMI.2.Elderly patients with AMI often have no obvious inducement before the onset,and a large proportion of patients often have atypical clinical symptoms,so pay attention to prevent missed diagnosis,so as to avoid the delay of the disease.3.The level of triglyceride in young and middle-aged AMI patients is higher than that in the elderly group,so it is necessary to strengthen the management of triglyceride in young and middle-aged AMI patients.4.The coronary arteries of elderly AMI patients are often multi-vessel lesions with severe cardiac function damage,and the possibility of complications during hospitalization is high. |
PDF Full Text Request