Risk Factors and In-hospital Outcome of Young Adults Presented with Acute Myocardial Infarction and Treated with Primary PCI

Abstract

Background: Acute myocardial infarction (AMI) is often characterised pathologically as the death of cardiomyocytes as a consequence of persistent ischaemia result in an acute imbalance among oxygen supply and demand. Coronary artery disease (CAD) is the leading cause of death worldwide. AMI mainly affects patients older than 40 years of age, however, young can suffer MI. In the developing countries, CAD is becoming an epidemic, where it occurs in younger persons at greater rates. Clinical features and prognosis of young patients tend to vary from those of older individuals. the outcomes of a MI may be especially severe at a young age because of its larger potential influence on the patient's psyche, capacity to work, and socioeconomic burden. AMI is less prevalent in young people than in older persons, since only 2 to 6 % of the younger population suffers from the condition. Primary PCI is the optimal therapy for STEMI if it can be done promptly, preferably within 90-120 minutes of provider contact. Methods: The present research performed on 60 subjects who had AMI and treated with primary PCI. The cases were allocated into 2 groups, group 1 involved young subjects aged 40 years old or less (30 patients) and group 2 involved older patients aged more than 40 years (30 patients). All patients underwent complete history taking, cardiological clinical examination, investigations, coronary angiography and PCI. Results: Concerning age there was statistically significant difference among two groups while there was no significant difference regarding to sex. regarding risk factors there was significant difference among both groups regarding to hypertension, DM, previous MI, cerebrovascular disease and drug abuse. Regarding to laboratory investigation, there was no significant difference regarding CK, CKMB, creatinine and random blood sugar. There was no significant difference regarding to culprit artery and TIMI flow after PCI while there was statistically significant difference regarding number of vessels involved. Regarding to outcome there was no significant variation among the two groups regarding to acute HF, cardiogenic shock, re-infarction, and death. As regarding to bleeding, it was significant higher in group II. Conclusions: Prevalence of Acute ST Elevation Myocardial Infarction “STEMI” in young people is increasing due to sedentary and stressful lifestyle and bad habits as smoking and addiction. The most widespread and important risk factors in these patients are smoking, addiction, mental stress and hyperlipidemia with less prevalence of hypertension and diabetes mellitus. Young patients present most commonly with anterior then inferior STEMI.