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ȣ - 510197 67 |
| Clinical Characteristics and Outcomes of Younger Age AMI |
| 고려대학교 구로병원 순환기내과¹ , 전남대학교 순환기내과² |
| Yoshiyasu Minami¹, 나승운¹ , Zhe Jin¹ , Kang-yin Chen¹ , 나진오¹ , 서순용¹ , 최철웅¹ , 김진원¹ , 김응주¹ , 박창규¹ , 서홍석¹ , 오동주¹ ,정명호² |
Background: We sometimes experience unexpected acute myocardial infarction (AMI) in very young age. Although it’s clinical feature and outcomes have been sparsely reported, but the details remain largely unknown. We evaluated the clinical characteristics and outcomes of AMI in younger patients with less than 40-year old.
Methods: In this study, a total 7,812 AMI patients were enrolled in the KAMIR (Korean Acute Myocardial Infarction Registry) from September 2005 to December 2006. We evaluated the clinical characteristics and in-hospital outcomes of younger AMI patients (<40-year old; mean 35.0±4.3; n=222) compared with those of older AMI patient (≥40-year old; 64.3±11.8; n=6828).
Results: The rate of male (95.5% vs 65.2, p<0.01), smoker (86.5% vs 57.2, p<0.01) and family history of ischemic heart disease (18.8% vs 6.8%, p<0.01), Body mass index (BMI, 26.3±3.9 vs 23.8±3.1, p<0.01) and total cholesterol (192.0±47.8 vs 182.2±45.0mg/dl, p<0.01) were significant higher in the younger group. But the rate of hypertension (29.4% vs 49.9, p<0.01) and diabetes (10.9% vs 28.8, p<0.01) was significantly lower in the younger group. The Killip class 3 or 4 (5.9% vs 13.7%, p<0.01), Left ventricular ejection fraction on echo cardiogram (53.0±11.1% vs 50.9±12.7%, p=001) and angiographic findings (the rate of multivessel and/or left main disease) were favorable in the younger group. Although the procedural success rate was similar between the two groups (88.3% vs 88.2, p=0.98), but the rate of coronary care unit (36.7% vs 82.1%, p<0.01) and overall in-hospital complications (10.9% vs 14.0%, p=0.07) were lower in the younger group. In-hospital survival rate was significant higher in the younger group (99.5% vs 94.8%, p<0.01).
Conclusions: In-hospital clinical outcomes of younger AMI patients were better than those of older patients. Typical clinical characteristics of young AMI patients should be translated into clinical practice to reduce acute coronary syndrome with younger age. Long-term clinical outcomes of this particular subset of patients should be evaluated with larger study populations.
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