İrfan Veysel DÜZEN, Yusuf ÇEKİCİ

Predictors of multivessel involvement in patients under 40 years of age receiving primary PTCA for STEMI

Aim: The angiographic features of myocardial infarction in young patients and the factors affecting these features differ from those in elderly patients and have not been fully established. The aim of this study was to investigate the factors involved in the development of multivessel disease in patients aged 40 years or younger with ST-segment elevation myocardial infarction (STEMI).Material and Methods: A total of 148 patients aged 40 years or younger who underwent primary percutaneoustransluminal coronary angioplasty for STEMI were included in the study. The demographic features, angiographic features, biochemical data and risk factors of the patients were reviewed retrospectively.Results: Assessment of the risk factors showed that 91.2% of the patients were male, 73% were smokers, 56.8% were hyperlipidemic, 36.1% were hypertensive and 23.1% had diabetes mellitus. A positive family history was present in 31.1% of the patients. Hyperlipidemia was significantly more common (p=0.008) and the hemoglobin values were significantly lower (p

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1. National Center for Health Statistics. Health, United States, 2017: with special feature on death and dying. Available at: https://www.cdc.gov/nchs/hus.htm.
2. McManus DD Gore J, Yarzebski J, Spencer F, et al. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med 2011;124:40-7.
3. Sugiyama T, Hasegawa K, Kobayashi Y, et al. Differential time trends of outcomes and costs of care for acute myocardial infarction hospitalizations by ST elevation and type of intervention in the United States, 2001-2011. J Am Heart Assoc 2015;3:001445.
4. Khera S, Kolte D, Gupta T, et al. Temporal trends and sex differences in revascularization and outcomes of ST-segment elevation myocardial infarction in younger adults in the United States. J Am Coll Cardiol. 2015;66:1961-72.
5. Zimmerman FH, Cameron A, Fisher LD, et al. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis. J Am Coll Cardiol 1995;26:654-61
6. Maroszynska-Dmoch EM, Wozakowska-Kapton B. Clinical and angiographic characteristics of coronary artery disease in young adults. Kardiol Pol 2016;74:314-21
7. Trzeciak P, Gierlotka M, Gąsior M, et al. In-hospital and 12-month outcomes after acute coronary syndrome treatment in patients aged<40 years of age (from the Polish Registry of Acute Coronary Syndromes). Am J Cardiol 2014;114:175-80.
8. Matsis K, Holley A, Al-Sinan A, et al. Differing clinical characteristics between young and older patients presenting with myocardial infarction. Heart Lung Circ 2017;26:566-71.
9. Barbash GI, White HD, Modan M, et al. Acute myocardial infarction in the young--the role of smoking. The Investigators of the International Tissue Plasminogen Activator/Streptokinase Mortality Trial. Eur Heart J 1995;16:313-6.
10. Chan MY, Woo KS, Wong HB, et al. Antecedent risk factors and their control in young patients with a first myocardial infarction. Singapore Med J 2006;47:27-30.
11. Colkesen AY, Acil T, Demircan S, et al. Coronary lesion type, location, and characteristics of acute ST elevation myocardial infarction in young adults under 35 years of age. Coron Artery Dis. 2008;19:345-7.
12. Melidonis A,Dimopoulos V, Lempidakis E, et al. Angiographic study of coronary artery disease in diabetic patients in comparison with nondiabetic patients. Angiology 1999;50:997-1006.
13. Ge J, Li J, Yu H, et al. Hypertension is an independent predictor of multivessel coronary artey disease in young adults with acute coronary syndrome. Int J Hypertens. 2018;2018:7623639.
14. Dib JG, Alameddine Y, Geitany R, Afiouni F. National Cholesterol Education Panel III performance in preventing myocardialin farction in youngadults Ann Saudi Med 2008;28:22-7.
15. Akosah KO, Schaper A, Cogbill C, et al. Preventing myocardial infarction in the young adult in the first place: how do the National Cholesterol Education Panel III guidelines perform? J Am Coll Cardiol 2003;41:1475-9.
16. AbdAlamir M, Goyfman M, Chaus A, et al. The correlation of dyslipidemia with the extent of coronary artery disease in the multiethnic study of atherosclerosis. J Lipids. 2018;2018:5607349.
17. Goliasch G, Oravec S, Blessberger H, et al. Relative importance of different lipid risk factors for the development of myocardial infarction at a very young age (≤ 40 years of age). Eur J Clin Invest. 2012;42:631-6.
18. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17; 364(9438):937-52.
19. Chan CM, Chen WL ,Kuo HY, et al. Circadian variation of acute myocardial infarction in young people. Am J Emerg Med. 2012;30:1461-5.
20. Mozos I. Mechanisms linking red blood cell disorders and cardiovascular diseases. Biomed Res Int. 2015;2015:682054.
21. Tsujita K, Nikolsky E, Lansky AJ, et al. Impact of anemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy (from the HORIZONS-AMI trial).Am J Cardiol.2010;105:1385-94.
22. Kurek T, Lenarczyk R, Kowalczyk J, et al. Effect of anemia in high-risk groups of patients with acute myocardial infarction treated with percutaneous coronary intervention. Am J Cardiol 2010;105:611-8.
23. Tripathi B, Yeh RW, Bavishi CP, et al. Etiologies, trends, and predictors of readmission in ST-elevation myocardial infarction patientsundergoing multivessel percutaneous coronary intervention. Catheter CardiovascInterv. Epub ahead of print: Jun 4, 2019.
24. Jones DA, Rathod VS, Bromage D, et al. Prognostic impact of anaemia on patients with ST-elevation myocardial infarction treated by primary PCI. Coron Artery Dis. 2014;25:52-9.
25. Steinvil A, Banai S, Leshem-Rubinow E, et al. The development of anemia of inflammation during acute myocardial infarction. Int J Cardiol. 2012;156:160-4.
26. Celik A, Karayakali M, Altunkas F, et al. Red cell distribution width is correlated with extensive coronary artery disease in patients with diabetes mellitus. Cardiovasc J Afr. 2017;28:319-23.