Characteristics And Outcomes In Young Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Objective:To analyze the clinical and angiographic characteristics and to explore the long-term outcome in young patients with acute myocardial infarction undergoing percutaneous coronary intervention.Methods:Of the411consecutive patients in our institution between January2005and December2009, who were diagnosed as AMI and underwent percutaneous coronary intervention (PCI), young group were73patients [≤44years old (a median of40±5years old)]. and old group were338patients [≥60years old (a median of68±6years old)]. Medical histories, coronary anatomy, outcomes and long-term follow-up (a median of3.5±1.3years) were evaluated.Results:Male (97.3%), current smoking (83.6%), drinking abuse (27.4%) positive family history (19.2%) and extreme fatigue incentives (31.5%) were more frequent and body mass index (BMI)(26.14±3.56), triglyceride (TG) levels (2.25±1.39) were higher in young patients, compared to old patients. Whereas, patients in the young group had less hypertension history (46.6%), prior stroke history (2.7%) and premonitory symptom (16.4%), and had lower high density lipoprotein-cholesterol (HDL-C)(0.98±0.24) and serum uric acid (309.26±92.60). The young patients were more likely to both have angiographically single-vessel (45.2%vs.25.1%, χ2=11.800, P<0.01) and left anterior descending artery (58.9%vs.40.5%,χ2=8.232. P<0.01) diseases than old patients. During the follow-up period, the MACE, which was composed by cardiovascular death, non-death myocardial infarction and cerebrovascular accident, was significantly lower (0vs.7.4%, χ2=4.527, P<0.05) in the young than in the old groups.Conclusion:Smoking, drinking, positive family history, fat and dyslipoproteinemia were major risk factors for AMI in the young patients. They mostly had extreme fatigue incentives and seldom typical premonitory clinical symptoms. The young patients with AMI tended to have more single-vessel disease, involving the left anterior descending artery, and had a favorable prognosis in long term compared with old patients, so we suggest that the young patients should be performed PCI as soon as possible.