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Clinical, Laboratory and Angiographic Features in Young Myocardial Infarct: A multicenter retrospective study

Year 2022, Volume: 9 Issue: 1, 126 - 130, 31.03.2022
https://doi.org/10.34087/cbusbed.1030219

Abstract

Objective: Our aim in this study was to compare the clinical, laboratory and angiographic features of patients under 45 years of age hospitalized with acute coronary syndrome (heart attack with ST-segment elevation and heart attack without ST-segment elevation) with those in the middle-aged group aged 45-65 years.
Materials and Methods: The study was planned retrospectively. The files of patients admitted to our clinic with the diagnosis of acute coronary syndrome and undergoing coronary angiography for the first time were scanned. Those aged 45 and under were considered as young heart attacks, while those over 45 and 65 years of age and under were considered as the control group.
Results: In univariate logistic regression analysis results, hypertension (odds ratio (OR): 4.367, 95% confidence interval (CI) [2.631-7.248], p<0.001), DM (OR: 3.252, 95% CI [1.952-5.417]), p<0.001), smoking (OR: 0.614, 95% CI [0.405-0.929], p=0.021), serum glucose level (OR:0.995, 95% CI [0.992-0.998], p=0.003) and frontal QRS While the -T angle (OR: 0.995, 95% CI [0.990-0.999], p=0.017) was significant, multivariate regression analysis showed hypertension (OR: 3.403, 95% CI [1.996-5.801], p<0.001) was determined as possible independent risk factors.
Conclusion: As a result, hypertension, diabetes and smoking were found to be the leading causes of heart attack in young patients. Young patients with these risk factors should be examined for coronary artery disease and earlier treatments such as statins and acetylsalicylic acid should be considered. In addition, early diagnosis and treatment of risk factors such as DM, HT and smoking in these patients can prevent the development of heart attack in the young patient group.

References

  • Rana, J.S, Khan, S.S, Lloyd-Jones, D.M, et al., Changes in Mortality in Top 10 Causes of Death from 2011 to 2018, Journal of General Internal Medicine, 2021, 36(8), 2517-8.
  • [Jurisch, D, Laufs, U, Chronic coronary syndrome: New classification of stable coronary artery disease, Der Internist, 2021, 62(1), 47-57.
  • Collet, J.P, Thiele, H, Barbato, E, et al., 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation, European Heart Journal, 2021, 42(14), 1289-367.
  • Fournier, J.A, Sánchez, A, Quero, J, et al., Myocardial infarction in men aged 40 years or less: a prospective clinical-angiographic study, Clinical Cardiology, 1996, 19(8), 631-6.
  • Doughty, M, Mehta R, Bruckman, D, et al., Acute myocardial infarction in the young--The University of Michigan experience, American Heart Journal, 2002, 143(1), 56-62.
  • Mitchell, C, Rahko, P.S, Blauwet, L.A, et al., Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography, Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography, 2019, 32(1), 1-64.
  • Chow, C.K, Teo, K.K, Rangarajan, S, et al., Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries, Jama, 2013, 310(9), 959-68.
  • Qing, Q, Gang, H, Jaakko, T, Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts, Diabetes Care, 2003, 26(1), 61-9.
  • Srinivasan, M.P, Kamath, P.K, Bhat, N.M, et al., Severity of coronary artery disease in type 2 diabetes mellitus: Does the timing matter?, Indian Heart Journal, 2016, 68(2), 158-63.
  • Shaye, K, Amir, T, Shlomo, S, et al., Fasting glucose levels within the high normal range predict cardiovascular outcome, American Heart Journal, 2012, 164(1), 111-6.
  • Lewington, S, Clarke, R, Qizilbash, N, et al., Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies, Lancet, 2002, 360(9349), 1903-13.
  • Zimmerman, F.H, Cameron, A, Fisher, L.D, et al., Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry), Journal American College of Cardiology, 1995, 26(3), 654-61.
  • Usalp, S, Altuntaş, E., Bağırtan, B, et al., Stabil anjina pektoris ile başvuran hastalarda koroner yavaş akımın klinik ve laboratuvar belirleyicileri, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2021, 8(4), 691-96.

Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma

Year 2022, Volume: 9 Issue: 1, 126 - 130, 31.03.2022
https://doi.org/10.34087/cbusbed.1030219

Abstract

Giriş ve Amaç: 45 yaş altında akut koroner sendrom (ST segment yükselmeli kalp krizi ve ST segment yükselmesi olmayan kalp krizi) ile yatırılan hastaların klinik, laboratuvar ve anjiyografi özelliklerini 45-65 yaş arasındaki orta yaş grubundaki hastalarla karşılaştırmak amacı ile bu çalışma planlandı.
Gereç ve Yöntemler: Çalışma retrospektif olarak planlamıştır. Akut koroner sendrom tanısı ile yatırılan ve ilk defa koroner anjiyografi yapılan hastaların dosyaları taranmıştır. 45 yaş ve altında olanlar genç kalp krizi olarak kabul edilirken 45 yaş üstü ve 65 yaş ve altı olanlar kontrol grubu olarak kabul edilmiştir.
Bulgular: Tek değişkenli lojistik regresyon analiz sonuçlarında, hipertansiyon (odds oranı (OO): 4.367, %95 güven aralığı (GA) [2.631-7.248], p<0.001), DM (OO: 3.252, %95 GA [1.952-5.417], p<0.001), sigara içiciliği (OO: 0.614, %95 GA [0.405-0.929], p=0.021), serum glikoz düzeyi (OO:0.995, %95 GA [0.992-0.998], p=0.003) çok değişkenli regresyon analizlerinde hipertansiyon (OO: 3.403, %95 GA [1.996-5.801], p<0.001) olası bağımsız birer risk faktörü olarak saptandı.
Sonuç: Sonuç olarak hipertansiyon, diyabet ve sigara genç hastalarda öne çıkan kalp krizi nedenleri olarak bulunmuştur. Bu risk faktörlerine sahip genç hastalar KAH yönünden tetkik edilmeli ve KAH hastalığı yönünden riskli kabul edilerek statin, asetilsalisik asit gibi tedaviler daha erken başlanması düşünülmelidir. Ayrıca bu hastalar da DM, HT, sigara gibi risk faktörlerinin erken tanısı ve tedavisi ile genç hasta grubunda kalp krizi gelişimi önlenebilir.

References

  • Rana, J.S, Khan, S.S, Lloyd-Jones, D.M, et al., Changes in Mortality in Top 10 Causes of Death from 2011 to 2018, Journal of General Internal Medicine, 2021, 36(8), 2517-8.
  • [Jurisch, D, Laufs, U, Chronic coronary syndrome: New classification of stable coronary artery disease, Der Internist, 2021, 62(1), 47-57.
  • Collet, J.P, Thiele, H, Barbato, E, et al., 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation, European Heart Journal, 2021, 42(14), 1289-367.
  • Fournier, J.A, Sánchez, A, Quero, J, et al., Myocardial infarction in men aged 40 years or less: a prospective clinical-angiographic study, Clinical Cardiology, 1996, 19(8), 631-6.
  • Doughty, M, Mehta R, Bruckman, D, et al., Acute myocardial infarction in the young--The University of Michigan experience, American Heart Journal, 2002, 143(1), 56-62.
  • Mitchell, C, Rahko, P.S, Blauwet, L.A, et al., Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography, Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography, 2019, 32(1), 1-64.
  • Chow, C.K, Teo, K.K, Rangarajan, S, et al., Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries, Jama, 2013, 310(9), 959-68.
  • Qing, Q, Gang, H, Jaakko, T, Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts, Diabetes Care, 2003, 26(1), 61-9.
  • Srinivasan, M.P, Kamath, P.K, Bhat, N.M, et al., Severity of coronary artery disease in type 2 diabetes mellitus: Does the timing matter?, Indian Heart Journal, 2016, 68(2), 158-63.
  • Shaye, K, Amir, T, Shlomo, S, et al., Fasting glucose levels within the high normal range predict cardiovascular outcome, American Heart Journal, 2012, 164(1), 111-6.
  • Lewington, S, Clarke, R, Qizilbash, N, et al., Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies, Lancet, 2002, 360(9349), 1903-13.
  • Zimmerman, F.H, Cameron, A, Fisher, L.D, et al., Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry), Journal American College of Cardiology, 1995, 26(3), 654-61.
  • Usalp, S, Altuntaş, E., Bağırtan, B, et al., Stabil anjina pektoris ile başvuran hastalarda koroner yavaş akımın klinik ve laboratuvar belirleyicileri, Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2021, 8(4), 691-96.
There are 13 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Araştırma Makalesi
Authors

Ramazan Gündüz 0000-0001-7133-4604

Songül Usalp 0000-0001-9572-5431

Publication Date March 31, 2022
Published in Issue Year 2022 Volume: 9 Issue: 1

Cite

APA Gündüz, R., & Usalp, S. (2022). Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 9(1), 126-130. https://doi.org/10.34087/cbusbed.1030219
AMA Gündüz R, Usalp S. Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. March 2022;9(1):126-130. doi:10.34087/cbusbed.1030219
Chicago Gündüz, Ramazan, and Songül Usalp. “Genç Kalp Krizlerinde Klinik, Laboratuvar Ve Anjiyografi Özellikleri: Çok Merkezli Retrospektif çalışma”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9, no. 1 (March 2022): 126-30. https://doi.org/10.34087/cbusbed.1030219.
EndNote Gündüz R, Usalp S (March 1, 2022) Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9 1 126–130.
IEEE R. Gündüz and S. Usalp, “Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma”, CBU-SBED: Celal Bayar University-Health Sciences Institute Journal, vol. 9, no. 1, pp. 126–130, 2022, doi: 10.34087/cbusbed.1030219.
ISNAD Gündüz, Ramazan - Usalp, Songül. “Genç Kalp Krizlerinde Klinik, Laboratuvar Ve Anjiyografi Özellikleri: Çok Merkezli Retrospektif çalışma”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9/1 (March 2022), 126-130. https://doi.org/10.34087/cbusbed.1030219.
JAMA Gündüz R, Usalp S. Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2022;9:126–130.
MLA Gündüz, Ramazan and Songül Usalp. “Genç Kalp Krizlerinde Klinik, Laboratuvar Ve Anjiyografi Özellikleri: Çok Merkezli Retrospektif çalışma”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 9, no. 1, 2022, pp. 126-30, doi:10.34087/cbusbed.1030219.
Vancouver Gündüz R, Usalp S. Genç Kalp Krizlerinde Klinik, Laboratuvar ve Anjiyografi Özellikleri: Çok merkezli retrospektif çalışma. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2022;9(1):126-30.