Comparison Of Risk Factors And Rhythmic Characteristics Among Patients With Acute Myocardial Infarct In Different Ages

Objective: Incidence of acute myocardial infarction(AMI)increased rapidly among young individuals around the world,especially in China.However,the epidemiology and clinical characteristics of such patients had not been fully investigated.Methods: A multicenter observational study was done to explore the potential risk factors and rhythmicity pattern among such patients also the difference against those of old.380 inward patients with AMI(including young population age ? 45 years and old ones ? 65 years)were included from 4 different centers between January 1,2015 and December 31,2016.Risk factors,clinical features,coronary lesion severity,and other relative information were extracted from patients' electronic medical record.We also collected 24 patients(12 young AMI patients and old AMI patents)and analyzed expression of CLOCK gene and TM-1 gene.Results: Among the enrolled 380 patients,143(37.63%)were aged ? 45 years and the rest 237(62.37%)were aged ? 65 years.Compared with older patients,male gender and smoking were the most common risk factors of young patients with AMI.Hypertension,diabetes mellitus and stroke were higher in old patients.However,family history of coronary artery disease did not show significantly different.Coronary angiography showed a higher prevalence of single-vessel disease and lower Gensini score among young patients than those among the elderly counterparts,however,no statistical significance of left anterior descending artery involvement between these two groups.Levels of total cholesterol,LDL cholesterol and triglycerides were higher among young patients as well as LVEDd.Incidence of AMI within 24 hours and one year showed different onset patterns among young patients compared with those of elderly patients.The mortality and hospital stays were lower among young patients.Compared with old patients,the young patients have higher AMI incidence in 06:00-12:00,and the expression of CLOCK gene is higher in young patients and the expression of TM-1 gene is lower in this group when compared with old AMI patients.Conclusion: Smoking and male gender were the major risk factors of young patients with AMI,who often had less extensive coronary artery stenosis and better prognosis compared with elderly ones.And our study also showed different circadian patterns of such populations within 24 hours and one year versus old ones.