Risk factors profile for myocardial infarction: Focus at a young age
I.A. Novikova¹, O.V. Kchlynova², L.A. Nekrutenko²
¹S.G. Sukhanov’s Federal Center of Cardiovascular Surgery, 35 Marshala Zhukova St., Perm, 614013, Russian Federation
²Academician E.A. Wagner’s Perm State Medical University, 26 Petropavlovskaya St., Perm, 614094, Russian Federation
The paper focuses on examining peculiarities of risk factors causing cardiac infarction at a young age. Although cardiac infarction primarily occurs among patients older than 45, its frequency at a young age has been growing recently. Risk factors that cause cardiac infarction at a young and old age are quite different. Examining risk factors profiles in different age groups provides wider opportunities for implementing primary and secondary prevention strategies aimed at reducing frequency and negative outcomes of ischemic heart disease.
108 patients aged from 18 to 45 and 35 patients aged from 60 to 75 took part in the research; they all had confirmed cardiac infarction with or without rise in ST segment and were treated in a regional center for cardiovascular pathology treatment in a period from January 01, 2017 to January 01, 2019. Basic risk factors of cardiac infarction were assessed when a patient was admitted to a clinic for treatment.
The research results indicate high prevalence of risk factors that could cause ischemic heart disease among young patients. 92.2 % young patients have dyslipidemia, 70.2 % smoke, 68.5 have low physical activity, 68.2 % suffer from overweight and obesity, 58.8 % have arterial hypertension, 7.4 % suffer from type II pancreatic diabetes, and disorders in tolerance to carbohydrates was reveled in 15.7 % cases. Such factors as male sex (85.2 vs. 37.1 %, р=0,000), smoking (70.2 vs. 20.6 %, р=0.000) and burdened heredity as per early ischemic heart disease occurrence (54.6 vs. 16.0 %, р=0.001) were significantly more frequent among young patients than among older ones.
Data obtained via the present research allowed creating risk factors profile for cardiac infarction associated with cardiac infarction occurrence at a young age; this profile included such factors as male sex, early ischemic heart disease occurrence in family history, and smoking.
- Krittanawong C., Liu Y., Mahtta D., Narasimhan B., Wang Z., Jneid H., Tamis-Holland J.E., Mahboob A. [et al.]. Non-traditional risk factors and the risk of myocardial infarction in the young in the US population-based cohort. Int. J. Cardiol. Heart Vasc, 2020, vol. 30, pp. e100634. DOI: 10.1016/j.ijcha.2020.100634
- Egred M., Viswanathan G., Davis G.K. Myocardial infarction in young adults. Postgrad. Med. J, 2005, vol. 81, no. 962, pp. 741–745. DOI: 10.1136/pgmj.2004.027532
- Yusuf S., Hawken S., Ounpuu S., Dans T., Avezum A., Lanas F., McQueen M., Budaj A. [et al.]. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004, vol. 364, pp. 937–952. DOI: 10.1016/S0140-6736(04)17018-9
- Lisowska A., Makarewicz-Wujec M., Filipiak K.J. Risk factors, prognosis, and secondary prevention of myocardial infarction in young adults in Poland. Kardiol. Pol, 2016, vol. 74, no. 10. pp. 1148–1153. DOI: 10.5603/KP.a2016.0098
- Zhang W., Yuan Z., Liu Y., Jia L., Cheng H., Qi J., Wu H., Wang Y., Wang D. [et al.]. Risk factors and coronary an-giographic findings in young and elderly patients with acute myocardial infarction: a comparative analysis. Nan Fang Yi Ke Da Xue Xue Bao, 2008, vol. 28, no. 5. pp. 718–721 (in Chinese).
- Hoit B.D., Gilpin E.A., Henning H., Maisel A.A., Dittrich H., Ross Jr. J. Myocardial infarction in young patients: an analysis by age subsets. Circulation, 1986, vol. 74, pp. 712–721. DOI: 10.1161/01.cir.74.4.712
- Chan M.Y., Woo K.S., Wong H.B., Chia B.L., Sutandar A., Tan. H.C. Antecedent risk factors and their control in young patients with a first myocardial infarction. Singapore Med. J., 2006, vol. 47, pp. 27–30.
- Zimmerman F.H., Cameron A., Fisher L.D., Grace N. Myocardial infarction in young adults: angiographic char-acterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). J. Am. Coll. Cardiol., 1995, vol. 26, pp. 654–661.
- Incalcaterra E., Caruso M., Lo Presti R., Caimi G. Myocardial infarction in young adults: risk factors, clinical charac-teristics and prognosis according to our experience. Clin. Ter., 2013, vol. 164, pp. e77–82. DOI: 10.7417/CT.2013.1535
- Popov S.V., Garganeeva A.A., Borel' K.N., Kuzheleva E.A., Okrugin S.A. Myocardial infarction in young patients: long-term analysis of appearance, clinical course and strategies of management. Kompleksnye problemy serdechno-sosudistykh zabolevanii, 2016, no. 4, pp. 66–72. DOI: 10.17802/2306-1278-2016-4-66-72 (in Russian).
- Ponomarenko I.V., Sukmanova I.A. Clinical data and hemodynamic parameters in young adults with acute coronary syndrome. Kompleksnye problemy serdechno-sosudistykh zabolevanii, 2018, vol. 7, no. 1, pp. 14–20. DOI: 10.17802/2306-1278-2018-7-1-14-20 (in Russian).
- Yandrapalli S., Nabors C., Goyal A., Aronow W.S., Frishman W.H. Modifiable Risk Factors in Young Adults With First Myocardial Infarction. J. Am. Coll. Cardiol, 2019, vol. 73, no. 5. pp. 573–584. DOI: 10.1016/j.jacc.2018.10.084
- Deora S., Kumar T., Ramalingam R., Manjunath C.N. Demographic and angiographic profile in premature cases of acute coronary syndrome: analysis of 820 young patients from South India. Cardiovasc. Diagn. Ther., 2016, vol. 6, no. 3, pp. 193–198. DOI: 10.21037/cdt.2016.03.05
- Shiraishi J., Kohno Y., Yamaguchi S., Arihara M., Hadase M., Hyogo M., Yagi T., Shima T. [et al.]. Acute myocardial infarction in young Japanese adults: Clinical manifestations and in-hospital outcome. Circ. J., 2005, no. 69, pp. 1454–1458. DOI: 10.1253/circj.69.1454
- Maas A., Appelman Y. Gender differences in coronary heart disease. Neth. Heart J., 2010, vol. 18, pp. 598–602. DOI: 10.1007/s12471-010-0841-y
- Mendelsohn M.E., Karas R.H. The protective effects of estrogen on the cardiovascular system. N. Engl. J. Med., 1999, vol. 340, pp. 1801–1811. DOI: 10.1056/NEJM199906103402306
- Subbiah M.T. Mechanisms of cardioprotection by estrogens. Proc. Soc. Exp. Biol. Med., 1998, vol. 217, no. 1, pp. 23–29. DOI: 10.3181/00379727-217-44201
- Chow C.K., Islam S., Bautista L., Rumboldt Z., Yusufali A., Xie C., Anand S.S., Engert J.C. [et al.]. Parental history and myocardial infarction risk across the world: the INTERHEART Study. J. Am. Coll. Cardiol., 2011, vol. 57, pp. 619–627. DOI: 10.1016/j.jacc.2010.07.054
- Hosseini S.K., Soleimani A., Karimi A.A., Sadeghian S., Darabian S., Abbasi S.H., Ahmadi S.H., Zoroufian A. [et al.]. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age. Monaldi Arch. Chest Dis., 2009, vol. 72, pp. 71–76. DOI: 10.4081/monaldi.2009.331
- Oliveira A., Barros H., Azevedo A., Bastos J., Lopes C. Impact of risk factors for non-fatal acute myocardial infarc-tion. Eur. J. Epidemiol., 2009, vol. 24, pp. 425–432. DOI: 10.1007/s10654-009-9352-9
- Gaeta G., De Michele M., Cuomo S., Guarini P., Foglia M.C., Bond M.G., Trevisan M. Arterial abnormalities in the offspring of patients with premature myocardial infarction. N. Engl. J. Med., 2000, vol. 343, no. 12, pp. 840–846. DOI: 10.1056/NEJM200009213431203
- Berenson G.S., Srinivasan S.R., Bao W., Newman W.P. 3rd, Tracy R.E., Wattigney W.A. Association between mul-tiple cardiovascular risk factors and atherosclerosis in children and young adults. N. Engl. J. Med., 1998, vol. 338, no. 23, pp. 1650–1656. DOI: 10.1056/NEJM199806043382302
- Broda G., Rywik S. Wieloośrodkowe ogólnopolskie badanie stanu zdrowia ludności – projekt WOBASZ. Kardiol. Pol., 2005, vol. 63, pp. 601–685.
- Messner B., Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early ath-erogenesis. Arterioscler. Thromb. Vasc. Biol., 2014, vol. 34, no. 3, pp. 509–515. DOI: 10.1161/ATVBAHA.113.300156
- Barbash G.I., White H.D., Modan M., Diaz R., Hampton J.R., Heikkila J., Kristinsson A., Moulopoulos S. [et al.]. Acute myocardial infarction in the young – the role of smoking. The Investigators of the International Tissue Plasminogen Acti-vator/Streptokinase Mortality Trial. Eur. Heart J., 1995, vol. 16, pp. 313–316.