| Objective To investigate the role of multiple clinical risk factors such as smoking history,hypertension,and diabetes in the pathogenesis and to analyze the characteristics of pathogenesis,coronary artery lesions,and prognosis of young patients with acute myocardial infarction.Methods we retrospectively reviewed and analyzed 281 the young patients(aged?44 years)with acute myocardial infarction(AMI)and compared with 300 non-Cardiovascular disease the young(aged?44 years)who had a physical examination at medical center of Second Hospital of Lanzhou,283 Middleaged and elderly people(aged 45-65 years old)with AMI as different ages case control group.all patients were admitted to Second Hospital of Lanzhou University from September 2014 to September 2017.Observation and analysis the correlation between smoking history,drinking history,serum uric acid,high-sensitivity C-reactive protein,white blood cell count,early family history of coronary heart disease,blood lipids,hypertension,white blood cell count,red blood cell distribution width SD,red blood cell distribution width CV,lipoprotein a,diabetes,fasting blood glucose,Serum homocysteine(Hcy),hemoglobin and other young adults with myocardial infarction.and the incidence of myocardial infarction in young adults..The severity of coronary lesions is indicated by the number of lesions based on the results of coronary angiography.The young myocardial infarction group was divided into young male MI subgroup and young female MI subgroup,then analysis the features of coronary artery lesions in young male MI subgroup and young female MI subgroup.Result(1)Compared with the normal control group,there was a significant increase in smoking history,obesity,combined hypertension,diabetes mellitus and premature family history of coronary heart disease in the young case group(P<0.05),body mass index,serum uric acid,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein,serum homocysteine and high sensitive C-reactive protein were higher(all P<0.05)and hemoglobin was lower(P<0.05).(2)Logistic regression analysis showed that the independent risk factors associated with acute myocardial infarction were obesity(OR = 3.784),smoking(OR = 158.595),family history of premature coronary heart disease(OR = 7.117),diabetes mellitus,Hypertension(OR = 11.911),high cholesterol(OR = 2.502),high triglyceride(OR = 1.398),low density lipoprotein(OR =12.059),high homocysteine(OR = 8.850),Hyperuricemia(OR=1.962),Hypohaemoglobinemia(OR=1.043)(all P <0.05).(3)Coronary angiography in acute myocardial infarction group showed that 16 cases were normal,accounting for 5.7%;122 cases were single-vessel disease,accounting for 43.4%;104 cases,accounting for 85.2%,had single-vessel disease involving anterior descending artery disease;82 cases,accounting for 29.2%;three lesions in 56 cases,accounting for 19.9%.Compared with middle-aged and elderly patients with acute myocardial infarction group,the single-vessel disease and the single anterior descending branch in the acute myocardial infarction group were significantly increased(all P <0.05).(4)Analysis of cardiac events during hospitalization of young acute myocardial infarction group showed that compared with middle-aged and elderly patients with acute myocardial infarction,the probability of cardiac arrhythmia,cardiogenic shock,papillary muscle rupture,heart failure and other cardiac events occurred is lower in young patients with acute myocardial infarction(P<0.05).(5)The clinical features and electrocardiogram localization of young with acute myocardial infarction group showed that compared with the middle-aged and elderly patients group with acute myocardial infarction,the onset of acute myocardial infarction in young patients was mainly typical of chest pain,and ECG analysis is more common in ST elevation myocardial infarction(P<0.05).(6)analysis of Cardiac Ultrasound in Youth with Acute Myocardial Infarction showed that compared with the middle-aged and elderly myocardial infarction group,the ejection fraction and left ventricular end diastolic diameter were normal in young myocardial infarction group(P<0.05).(7)There were only 17 female patients with acute myocardial infarction,and the incidence was significantly lower than that of men.Compared with young male acute myocardial infarction group,the proportion of zero lesions and single branch lesions in the group of young women with acute myocardial infarction was higher(all P < 0.05).three lesions were lower(P <0.05).this indicates that female or estrogen are protective factors of acute myocardial infarction.Conclusion Smoking,obesity,hypertension,diabetes,family history of premature coronary heart disease,elevated low-density lipoprotein,hyperhomocysteine,hypohemoglobinemia,and hyperuricemia are the major risk factors for acute myocardial infarction in young adults;the ECG of young patients with myocardial infarction was characterized by ST segment elevation myocardial infarction and and the main coronary artery lesions were the single branch of the anterior descending branch. |
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