| Objective: To analyze the clinical features,risk factors,coronary artery lesions,and in-hospital prognosis of acute myocardial infarction in patients under the age of 40.To explore the possible mechanism and analyze the influencing factors of complications in the patients during the hospital stay,and to provide an effective basis for the diagnosis and treatment of AMI.Methods: Collected baseline data,clinical characteristics and coronary lesion levels of 59 young AMI patients(?40 years old,young group)and compared with 70 aging AMI patients(?60 years old,old group),which treated in our hospital from 2015-01-01 to2017-07-01 were consecutively enrolled.The in-hospital incidence for Complications of AMI occurrence were compared,meanwhile,the in-hospital complications of young people AMI patient was analyzed by a Logistic regression analysis to determine the independent risk factor of complications.Results:(1)According to the research results show that two groups of patients with AMI were predominantly male,Among the young AMI patients,obesity or overweight,family history,hyperlipidemia,smoking,heavy drinking were higher than that of the old group,and the differences between the two groups had statistical significance(P<0.05).(2)Young patients admitted to hospital diastolic blood pressure were higher than old patients(84.56±17.56 mm Hg vs 77.17±16.50 mm Hg),the youth LVEF was greater than agedness(52.86±13.44 vs 43.79±12.32),among the young AMI patients,the levels of triglyceride,low-density lipoprotein cholesterol and apolipoprotein B were higher than that of the old group,but levels of the high-density lipoprotein cholesterol,apolipoprotein A1,fasting plasma glucosewere,blood uric acid,Cystatin C were less than that of the old group,and the differences between the two groups had statistical significance(P<0.05).(3)The occurrence rate of typical chest pain with young group were higher than the old,but the occurrence rate of prodrome were less than that of the old group,and the two groups were statistically significant(P < 0.05).Youth patients with typical chest pain condition is higher than the elderly group,so emergency surgery patients were more than the elderly group,33 cases(55.9%),and the advice and guidance of physician after admission condition,the elderly group patients undergoing elective surgery was more than youth,42cases(60.0%),the comparison of two groups was statistically significant(P < 0.05).The coronary angiography results in the young group was mostly coronary artery single vessel disease with 34 cases(57.6%),culprit vessels were mainly in left anterior descending artery.While the coronary angiography results in the older group was mostly coronary artery multivessel lesions with 28 cases(40.0%).Young AMI patients of coronary artery lesion vascular thrombosis load is heavier,there are 19 cases(about 32.2%),and its blood vessels diffuse lesions is less than the elderly,there are 15 cases(about 25.4%),2 groups of patients were compared with a significant difference(P < 0.05).(4)Young AMI patients with complications during hospitalization for 8 cases(13.6%),the condition of the elderly AMI for 24 cases(34.3%),youth during hospitalization in patients with AMI complications are more rare,difference was statistically significant(P = 0.007),the young AMI hospitalization concurrent malignant arrhythmia(P = 0.000),acute heart failure(P =0.027)were significantly lower than the chance of elderly patients with AMI.(5)Young people to develop the AMI independent impact factors are: family history of CHD positive[95% CI(1.460,1.460),P = 0.009],overweight or obese[95% CI(1.303,1.303),P =0.008],smoking[95% CI(1.162,1.162),P = 0.023].Independent risk factors that can predict the occurrence of complications during the hospitalization of young AMI patients:overweight or obese(OR=1.833,P=0.003),LVEF decreased(OR=2.438,P=0.001),and three vascular lesions(OR=5.265,P=0.000).Conclusion:(1)Young AMI patients were mainly in male gender,and young people with AMI are more likely to suffer from excessive drinking habits,and their blood lipid metabolism disorder is related to the levels of triglyceride,low-density lipoprotein cholesterol and apolipoprotein B.CHD positive family history,overweight or obesity,smoking is an independent risk factor for AMI in this group.(2)patients with AMI have typical chest pain,the occurrence rate of prodrome are not obvious,and mainly is ST-elevation myocardial infarction,and the most common wall of AMI in youth group is anterior wall and anteriorseptal myocardial infarction.(3)The coronary angiography results in the young group was mostly coronary artery single vessel disease,culprit vessels were mainly in left anterior descending artery,whose thrombus load was heavier than that of the elderly group.While the coronary angiography results in the older group was mostly three vascular lesions,and their vascular diffuse lesions are more common than those of young people.(4)Youth AMI patients during hospitalization complications was significantly less than the old,the youth of AMI patients hospitalized period concurrent risk of malignant arrhythmia,acute heart failure were significantly lower than the elderly.Logistic regression analysis found that overweight or obese,LVEF decreased,and three vascular lesions were independent risk factors for complications during the hospitalization of young AMI patients. |
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