Characteristic Of Coronary Lesions And Risk Factors Of Young Patients Suffering From ST-segment Elevation Myocardial Infarction

Background: The prevalent trend of cardiovascular risk factors is obvious in China.Cardiovascular disease is the leading cause of death in the urban and rural area.On average,2 out of every 5 deaths die from cardiovascular diseases which has become one of the major diseases threatening people's health.Acute myocardial infarction(AMI),as an important clinical classification of coronary heart disease(CHD),causing critical condition and high mortality,gives a heavy blow to life quality and working ability of young patients,also brings a heavy burden to their families and society.In recent years,the onset age of AMI tends to be younger.Studies have shown that about 2% to 10% of patients with acute myocardial infarction are younger than 45 years old.Acute myocardial infarction in young people urgently needs attention.There are few detailed studies on the characteristics of young patients with acute myocardial infarction in Xiangyang district.Objective: To summarize and analyze the risk factors,clinical profile and features of coronary artery lesions in young patients suffering from ST-segment elevation myocardial infarction(STEMI).To provide scientific basis for early prevention strategies of coronary heart disease in young people.Methods: A total of 151 patients who were diagnosed as STEMI and treated with primary percutaneous coronary intervention(PPCI),admitted to The Hospital of Xiangyang NO.1 People`s hospital during January 2017 to December2017,were continuously collected.The patients were divided into young group(age < 45,n = 12),middle-aged group(age < 45 and age < 60,n = 55)and old group(age < 60,n = 84)according to the age of onset.We compared and summarized the risk factors,clinical profile and features of coronary artery lesions between young STEMI patients,middle-aged STEMI patients and old STEMI patients.Results: There were significant differences in age,sex,BMI,smoking history,drinking history,hypertension history,family history of coronary heartdisease,area of myocardial infarction,the using of diuretic,the using of ACEI/ARB,WBC,RBC,Hb,ALT,GGT,Left anterior descending(LAD)artery lesion in single-vessel lesion,LAD as Criminal Vessel among the three groups of STEMI patients(all P < 0.05).Compared with old STEMI patients,the prevalence of smoking history,family history of coronary heart disease,anterior myocardial infarction,LAD artery lesion in single-vessel lesion,LAD as Criminal Vessel in young STEMI patients were significantly higher than that in old STEMI patients(all P < 0.05).the level of BMI,WBC,RBC,Hb,ALT,GGT and stent diameter in young STEMI patients were higher than that in old STEMI patients(all P< 0.05).the prevalence of hypertension history,angular lesion,Diffuse lesion in young STEMI patients were significantly lower than that in old STEMI patients(all P < 0.05).Binary Logistic analysis revealed that compared with old STEMI patients,smoking(OR=11.966,95%CI: 1.432?100.004,P<0.05)and family history of coronary heart disease(OR=26.056,95%CI: 1.418?478.830,P<0.05)were independent risk factor of young STEMI patients.Conclusion: Among all STEMI patients,young STEMI patients accounted for about 7.95%.The majority of young STEMI patients are male,and fewer suffer from hypertension.Coronary artery lesions in young STEMI patients are mostly simple.The Left anterior descending(LAD)artery is the main culprit vessel resulting in anterior wall myocardial infarction in young STEMI patients.Compared with old STEMI patients,Smoking and family history of coronary heart disease are the most common independent risk factor of young STEMI patients.Smoking cessation,weight reduction and lifestyle improvement are important strategies to prevent young people from developing STEMI,and it is more meaningful to young people with positive family history of coronary heart disease.