Study On Risk Factors And Clinical Characteristics Of First Acute Myocardial Infarction In The Young And Old Patients

Objective: This article is a controlled research, which is about risk factors, clinical characteristics, coronary angiography (CAG) results and clinical information of first acute myocardial infarction (AMI) in the young and old patients. To find the different clinical characteristics between the two groups, analyze the main risk factors and special clinical characteristics of young patients with AMI whose ages <45 years, and provide reference views for prevention and treatment of young patients with AMI. Then we can take more targeted measures to reduce morbidity and mortality of young AMI, and improve prognosis.Methods: We studied 103 first acute myocardial infarction patients who were from the first affiliated hospital of Dalian Medical University during Jan. 2008 to Dec. 2010 by random, including 34 cases of AMI whose ages <45 years and 69 cases of AMI whose ages≥60 years. Collected the data of gender, age, blood pressure, lipid, blood glucose, lipoprotein a, high sensitivity C-reaction protein, smoking history, and family history of premature coronary heart disease. Collected the data of the triggers, angina pectoris history, typical ischemic chest pain, heart arrhythmia, color doppler echocardiography, coronary angiography, and Killip classification. All data were analyzed with SPSS11.5 software.Results:1. There was a significant difference between the two groups in sex, smoking history, hypertension (P<0.01). The proportion of young group was higher than the old group in family history of premature coronary heart disease, there was a difference between the two groups (P<0.05). The proportion of young group was lower than old group in diabetes, there was a difference between the two groups (P<0.05). 2. There were no difference in Lipoprotein a, hs-CRP between the two groups (P>0.05). Comparison of blood lipid level between two groups after the admission, triglyceride level in young group were higher than old group, there was difference between the two groups (P<0.05), but no differences in total cholesterol, low-density lipoprotein and high-density lipoprotein (P>0.05).3. The proportion of patients with the AMI inducing factors, typical chest pain in young group was higher than old group, there was difference between the two groups (P<0.05). The proportion of patients with history of angina pectoris in young group was lower than old group, there was significant difference between the two groups (P<0.01).4. The proportion of patients with arrhythmia in young group was lower than the old and there was difference between the two groups (P<0.05).In Killip classification, the proportion of patients with KillipⅠin young group was higher than old group, there was significant difference between the two groups (P<0.01). The proportion of patients with KillipⅡin young group were lower than old groups, there was difference between the two groups (P<0.05), but KillipⅢ,Ⅳwas not difference (P>0.05).5. There was no difference in ventricular ejection fraction (LVEF) average and ventricular aneurysm between the two groups (P>0.05).6. The proportion of patients with single-vessel disease in young group was higher than the old group, there was significant difference between the two groups (P<0.01), but the proportion of patients with two-, three-vessel disease, diffuse disease and collateral circulation in young group was lower than the old group, there was difference between the two groups (P<0.05).Conclusions:1. Young men with AMI are significantly more than the women, those with a family history of premature coronary heart disease should be early followed up, checked on a regular basis and if necessary, drugs had better to be used.2. Smoking is a major risk factor in young patients with AMI, it should be strengthen to advocate the hazardous effects of tobacco on cardiovascular system, special for youth.3. Young patients with AMI have high blood triglyceride commonly, so they should take low-fat diet and improve the lifestyles to prevent incidence of acute myocardial infarction.4. Young patients with AMI have mostly inducing factors (great mental pressure, excessive fatigue, staying up late), sudden attack commonly, lack of prodrome, but with typical symptoms of ischemic chest pain. 5. Young patients with AMI have mostly single-vessel localized disease, fewer complications of acute myocardial infarction, lighter degree of heart failure and relatively better prognosis.