Author + information
- Nirav Desai,
- G. Andres Cortes,
- Kenneth Kita,
- Nazila Rad,
- David M. Shavelle,
- Anilkumar Mehra,
- Michael A. Gaglia Jr.,
- Ray V. Matthews and
- Leonardo Clavijo
The goal of the study is to investigate baseline risk factors, coronary artery angiogram results and interventions, and hospital outcomes in young patients with acute myocardial infarction (less than 45 years vs. older than 45 years of age).
Retrospective analysis of 779 patients treated with PCI for acute myocardial infarction (AMI) at the Los Angeles County Hospital + USC Medical Center and Keck Medical Center of USC between January 2008 and June 2011. Patients were divided into 2 groups according to age 81 young patients and 698 older patients. Baseline demographics, clinical characteristics, coronary angiogram results, PCI procedural information and hospital outcomes were compared.
Young patients (> 45 years old) represented 10.3% (n=81) of the total patient population (779 patients). Younger patients were found to have lower rates of diabetes (22.2% vs. 35.6%, p-value 0.03), more likely to be males (87.6% vs. 76%, p-value 0.02) and have higher triglyceride levels (212 mg/dl vs. 153.4 mg/dl, p-value 0.014). Young patients were less likely to have hypertension (41.8% vs. 66.8%, p-value < 0.0001). Both groups had similar rates of NSTEMI (44.4% vs. 49.7%, p-value 0.37) and STEMI (55.6% vs. 50.3%, p-value 0.37). Single vessel coronary artery disease was more prevalent in the younger group (71.7% vs. 44.6%, p-value <0.001) and had a higher rate of total occlusion of the infarct-related artery (39.7% vs. 19.1%, p-value 0.003). Rates of percutaneous coronary artery interventions (97.5% vs. 94%, p-value 0.3) and number coronary artery stent placement (1.5 vs. 1.8, p-value 0.26) were similar between both groups, while the younger group had a lower rate of post-intervention acute renal failure (1.4% vs. 9.5%, p-value 0.02). Length of total hospital stay (4.6 days vs. 6 days, p-value 0.15) and intensive care unit stay (2.9 days vs. 3.6 days, p-value 0.32) was also similar.
Younger age in patients with AMI is associated with male predominance, higher triglyceride levels, and higher rates of single vessel disease and total occlusion of the infarct related artery. Younger patients had a lower rate of post-procedure renal failure, while the remaining post-procedural outcomes and in-hospital mortality were similar.
- 2013 American College of Cardiology Foundation