Young Adults With Myocardial Infarction In Diabetes Mellitus And Non-diabetes

Objectives:To analyze risk factors,clinical features,biochemical marker and the stenosis extent of coronary artery in diabetic and non-diabetic young adults with myocardial infarction.Methods:Collected biochemical marker,medical history information and coronary angiography results among young patients(age?40years)with acute myocardial infarction in our hospital and coronary artery angiography diagnosis in January 2004 and December 2015 for the first time.A total of 94 patients met the inclusion criteria,the average age is 34.35±5.3 years old,among which 28 were diabetic patients,66 were nondiabetic patients.Two groups of patients with clinical features,biochemical marker and angiographic characteristics were compared and analysis by SPSS 17.0.Summarize the characteristics of young patients with myocardial infarction as a whole.Results:1.The morbidity of diabetes mellitus has developed in young adult with myocardial infarction,the morbidity of diabetes mellitus in young adult with myocardial infarction from 16.7% in January 2004-December 2015 to 27% January 2008-December2011 and the morbidity in January 2012-December 2015 has developed to 35.6%.2.In diabetic young adults with myocardial infarction,chest pain atypical cases(25% versus 7.6% P=0.048)and non-ST segment elevation myocardial infarction cases(50% versus 9.1% P=0.000)significantly higher than non-diabetic young adults with myocardial infarction.The increases of Gensini score(P=0.000),the incidence of double vessels(35.7% versus 21.2% P=0.000)and the incidence of triple vessels(39.3%versus 3.1% P=0.000)were noted in diabetic young adults with myocardial infarction.On the contrary,the incidence of single vessel lesion(21.4% versus 62.1%P=0.000),the presence of angiographically “normal” coronary arteries(3.6% versus13.6%.P=0.000)is lower in diabetic young adults with myocardial infarction compared to non-diabetic young adults with myocardial infarction.Among diabetic young adults with myocardial infarction the hospitalization days is longer(P=0.000),the prevalence of ventricular wall motion abnormalities is higher(78.6% versus 42.4% P=0.001)and the incidence of mortality is also noted(10.7% versus 1.5% P=0.043).3.On the whole,all the young patients with myocardial infarction usually has obvious chest pain(87.2%)and given priority to ST segment elevation myocardial infarction(78.7%)and lesions of anterior wall involved the most(51.3%).The stenosis of coronary artery in the young patients are mostly single lesions(50.1%),and anterior descending coronary artery takes the most(56.4%).The incidence of Killip?is most common(79.7%)According to Killip classification and prognosis of young patients with myocardial infarction is good and hospital deaths rate is low(4.2%).4.There are no significant differences between the two groups of whether with hypertension,hyperlipemia,hyperuricemia,alcohol abuse,family history of CHD,fatty liver(P>0.05).There were also no significant differences in the two groups with regard to cholesterol level,triglyceride level,concentration of bilirubin,creatinine level and cystatin C level.5.The young patients with myocardial infarction given priority to male(94.7%)and all the young patients with myocardial infarction have high prevalence of smoking(85.1%),logistic regression analysis showed that smoking and HbA1c was associated with Gensini score independently.Conclusions:1.The morbidity of diabetes mellitus has developed in young adult with myocardial infarction,in diabetic young adults with myocardial infarction,chest pain atypical cases and non-ST egment elevation myocardial infarction cases significantly higher than non-diabetic young adults with myocardial infarction.The increases of Gensini score,the incidence of double vessels and triple vessels were notedin diabetic young adults with myocardial infarction.Among diabetic young adults with myocardial infarction the hospitalization days is longer,the prevalence of ventricular wall motion abnormalities is higher,the prognosis is poorer and the incidence of mortality is also noted.2.Young patients with myocardial infarction given priority to male(94.7%)and all the young patients with myocardial infarction have high prevalence of smoking,logistic regression analysis showed that smoking and was associated with Gensini score independently.