The Clinical And Coronary Angiographic Characteristics Of Acute Myocardial Infarction In Young Adults

Objectives To observe risk factors， clinical manifestations， thecharacteristies of coronary angiography of the young Patients with acutemyocardial infarction (AMI)，The information about these may have aninfluence on the strategies for prevention and diagnosis for acutemyocardial infarction in young Patients.Methods313Patients with the first diagnosis of AMI were selected fromJanuary2007to Jane2011at the department of cardiology in FujianProvincial Hospital. All Patients were categorized into two groupaccording to age. Age less than45-year-old patients with AMI are definedas the young patients group (n=107)， and those60-75years with AMI aredefined as the older patients group (n=206). The risk factors，clinicalcharacteristics and the results of coronary angiography(CAG) of the youngpatients group and the older patients group were retrospectivelyanalyzed.Results1.Campared with the older patients group，the young patients group hadhigher rate of smoking，higher level of triglyceride(TG), higherproportion of family history of CHD(P<0.01);But had lower rate ofhypertension，diabetes mellitus(P<0.01)。the young patients group hadhigher proportion of one risk factor and two risk factors than the olderpatients group(P<0.01)，the young patients group had lower proportion ofthree risk factor and more than three risk factors than the olderpatients group(P<0.01)。2.Campared with the older patients group， smoking and alcohol abuse werethe induce factors in the attack of AMI in the young patients group(P <0.05)； proportion of repeated angina history in the young patientsgroup was lower than that in the older patients group(P <0.05), Incidenceof typical clinical manifestations in young patients group was higher thanthat in older patients group (P <0.05)；Rate of direct PCI therapy in youngpatients group was higher than that in older patients group (P <0.05);Incidence of single part MI in young patients group was higher than thatin older patients group (P <0.05); Incidence of much place MI in youngpatients group was lower than that in older patients group (P <0.05); therate of direct PCI therapy in young patients group was higher than thatin older patients group (P <0.05); Left ventricular ejection fraction inyoung patients group was higher than that in older patients group (P <0.01);Incidence of general complication in young patients group was lower thanthat in older patients group (P <0.01).3.Coronary angiogram showed that Single-vessel lesion in young patientsgroup was significantly higher than that in older patients group (P <0.01);two-vessel lesion and three-vessel lesion in young patients group waslower than that in older patients group (P <0.05; P <0.01); left maincoronary artery lesion in young patients group was lower than that in olderpatients group (P<0.05); The diffuse lesions changes and calcifiedlesions in young patients group were significantly less than that in olderpatients group(P<0.05);the formation of collateral circulation in youngpatients group was less than that in older patients group(P<0.05);Gensini’s scores of coronary artery in young patients group was less thanthat in older patients group(P<0.05)。Conclusion1.There were few risk factors for the young patients with AMI，Smokingwas the major risk factor for the young patients with AMI, High level oftriglyceride and family history of CHD were one of the important riskfactors.Excessive smoking and alcohol abuse were the induce factors in the attack of AMI. Its chest pain was typical， and the rate of directPCI therapy was high，treatment was positive, general complication waslow。2.For the young patients with AMI，single-vessel coronary was involvedmost frequently， and the left main coronary artery lesion was less；The diffuse lesions changes， calcified lesions and formation ofcollateral circulation were significantly less。3.Good habits，life style and timely reperfusion therapy are of greatsignificance to prevent disease and to improve prognosis.