The Study Of The Clinical And Coronary Artery Lesions Characteristics In Young Patients With Acute Myocardial Infarction

Objective:To evaluate the high risk factors of coronary heart disease and coronary artery lesions characteristics of young and elderly patients with acute myocardial infarction in order to understand the difference of young patients with AMI.Methods:According to the inclusion and exclusion criteria,94 young AMI patients with complete data who were hospitalized in the Department of Cardiology,Dali Bai Autonomous Prefecture People’s Hospital of Yunnan Province from September 1,2018 to August 31,2020 were collected(young group),and 100 elderly AMI patients who were hospitalized in the same period were randomly selected(old group).All the data of the selected cases were collected,such as name,age,the high risk factors of coronary heart disease(family history,body mass index,diabetes history,smoking history,etc.),blood pressure during hospitalization,related blood test indexes and coronary angiography results,etc.The high risk factors of coronary heart disease and coronary angiography results of young and elderly patients with AMI were compared,and the difference of young patients with AMI was statistically analyzed.Results:(1)Compared with the elderly patients with AMI,the risk factors of young patients with AMI were TC,LDL-C,TG,body mass index,family history of coronary heart disease,smoking history and male(P < 0.05),while the risk factors of elderly patients with AMI were age,diabetes and hypertension(P < 0.05).(2)The characteristics of coronary artery lesions were as follows,The coronary artery lesions of AMI in the young group were mostly single vessel lesions,while in the old group were multiple vessel lesion,and the difference was significant(P < 0.05).The left anterior descending branch of coronary artery was the most common involved vessel in both group.The left anterior descending branch was also the most common infarct related vessel of the young patients with AMI,while the elderly patients with AMI was right coronary artery,and with a significant difference(P < 0.05).The proportion of STEMI in the young group(67%)was significantly higher than that in the old group(52%),and the difference was statistically significant(P < 0.05).The Logistic regression analysis showed that smoking history was the most significant independent risk factor for acute myocardial infarction in the young people(OR=3.648,95%CI1.696-7.845,P=0.001),the other risk factors were hypertriglyceridemia(OR=3.329,95%CI 1.634-6.781,P=0.001)and body mass index(OR=2.778,95%CI 1.422-5.426,P=0.003),while the hypertension increased the risk of acute myocardial infarction in the old group(OR=0.235,95%CI 0.115-0.479,P=0.000).Conclusion:(1)Smoking history,TG and body mass index were independent risk factors of AMI in the young group,among which smoking history was the most important independent risk factor.(2)Compared with the elderly patients with AMI,the risk factors of young patients with AMI were TC,LDL-C,TG,body mass index,family history of coronary heart disease,smoking history and male.(3)The coronary artery lesions of AMI in the young group were mostly single vessel lesions.The left anterior descending branch of coronary artery were the most common involved vessel and infarct related artery in the young patients with AMI.Acute myocardial infarction in the young group is mainly STEMI.