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Risk Factors and Angiographic Characteristics of Coronary Artery Disease Requiring Revascularisation In Young Adults: A Single Centre Experience

Yıl 2019, , 59 - 72, 30.06.2019
https://doi.org/10.33716/bmedj.537719

Öz

Cardiovascular disease (CVD) is one of the most frequent cause of
mortality and morbidity world-wide. Advanced age is one of the most important
risk factor for progression of atherosclerosis and coronary artery disease
(CAD) is often seen over 45-years in male and 55 years in female population.
However, there is a significant increase in the prevalence of myocardial
infarction (MI) in young population recently. The aim of this study is to
identify the most prevalent risk factors for CAD in the young population who
presented with cardiac complaints and underwent coronary angiography (CAG) and
to determine the primary and secondary prevention strategies along with the
treatment strategies. Method: Young patients who have had cardiac complaints
and received CAG during the last 10 years were screened retrospectively.
Patient demographics, clinical characteristics and medications were collected
retrospectively from the review of the medical records and cardiac
catheterization database. A total of 113 cases were enrolled to the study. In
all patients CAG was performed. Subjects were then classified in to two main
groups according to their needs for revascularisation. Those subjects who
didn’t require coronary revascularisation after CAG were enrolled to the control
group (Group 1); and those who needed coronary revascularisation were enrolled
to the patient group (Group 2). SPSS 15.0 for Windows program was used for
statistical analysis. For categorical variables descriptive statistics were;
number and percentage. For numerical variables descriptive statistics were;
mean, standard deviation, minimum, maximum, median. When the independent
two-group comparisons of numerical variables provided normal distribution
condition the Student's t test was performed, while Mann-Whitney U test was
performed when the normal distribution condition was not met. Rates in
independent groups were compared with Chi square test. Statistical significance
level of alpha was accepted as p
<0,05. Results: The
prevalence of male gender was significantly higher than female gender among the
groups (p=0.002). There was no statistically significant difference between
groups in respect to mean value of BMI (p=0.105). Smoking and average number of
cigarettes smoked was significantly higher in Group 2 patients (p
<0.001; p=0.002). There were no statistically significant difference
between the groups regarding to their additional co-morbidities.

Kaynakça

  • 1. Roth GA, Huffman MD, Moran AE, Feigin V, Mensah GA, Naghavi M, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation 2015;132:1667–1678.
  • 2. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129: 49–73.
  • 3. Hong MK, Cho SY, Hong BK, Chang KJ, Chung IM, Lee MH, et al. Acute myocardial infarction in young adults. Yonsei Med J 1994;35:184-189.
  • 4. Jneid H, Fonarrow GC, Cannon CP, Hernandez AF, Palacios IF, Maree AO, et al. Sex differences in medical care and early death after acute myocardial infarction. Circulation 2008:118;2803-2810.
  • 5. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. Int J Cardiol 2011;148: 300–304.
  • 6. Singh A, Collins BA, GuptaA, Fatima A, Qamar A, Biery D, et al. . Cardiovascular risk and statin eligibility of young adults after an MI. JACC 2018;3: 292-302.
  • 7. Matsis K, Holley A, Al-Sinan A, Matsis P, Larsen PD, Harding SA, et al. Differing clinical characteristics between young and older patients presenting with myocardial infarction Circulation 2017;26:566-571.
  • 8. Bostom AG, Cupples LA, Jenner JL, Ordovas JM, Seman LJ, Wilson PW, et al. Elevated plasma lipoprotein (a) and coronary heart disease in men aged 55 years and younger. A prospective study. JAMA 1996;276: 544–548.
  • 9. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndroms in young patients: Presentation , treatment and outcome. Int J Cardiol 2011;148(3):300-304.
  • 10. Malik FTN, Kalimuddin , Ahmed N, Badiuzzzaman M, Ahmed MN, Dutta A , et al. AMI in young(aged<35 years) Bangladeshi patients: Risk factors & coronary angiographic profile. Clin Trials Regul Sci Cardiol 2016; 13:1-5.
  • 11. Feijó IP, Schmidt MM, David RB, Martins JMP, Schmidt KE, Gottschall CAM, et al. Clinical profile and outcomes of primary percutaneous coronary intervention in young patients. Rev Bras Cardiol Invasiva 2015;23:48-51.
  • 12. Beraldo de Andradea P, Rinaldia FS, Ribeiro de Castro Bienerta I, Barbosaa RA, Bergonsoa MH, Brasil de Matosa MP, et al. Clinical and angiographic profile of young patients undergoing primary percutaneous coronary intervention. Rev Bras Cardiol Invasiva 2015;23(2):91-95.
  • 13. Hoit BD, Gllipin EA, Henning H, Maisel AA, Dittrich H, Carlise J, et al. Myocardial infarction in young patients: an analysis by age subset. Circulation 1986;74:712-21.
  • 14. Oliveira A, Barros H, Maciel MJ, Lopes C. Tobacco smoking and acute myocardial infarction in young adults: a population-based case–control study. Prev Med 2007;44:311–316.
  • 15. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. Int J Cardiol 2011;148:300–304.
  • 16. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 1995;108:364-369.
  • 17. Tungsubutra W, Tresukosol D, Buddhari W, Boonsom W, Sanguanwang S, Srichaiveth B. Acute coronary syndrom in young adults: Thai ACS Registry. J Med Assoc Thai 2007 Oct:90 suppl 1:81-90.
  • 18. B Chandrasekaran, A S Kurbaan. Myocardial infarction with angiographically normal coronary arteries.JR Soc Med 2002;95: 398–400.
  • 19. Konishi H, Miyauchi K, Kasai T, Tsuboi S, Ogita M, Naito R, et al. Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention. J Cardiol 2014;64:171-174.
  • 20. Canto JG, Rogers WJ, Goldberg RJ, Peterson ED, Wenger NK, Vaccarino V, et al.Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012;307:813–822.
  • 21. Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry).J Am Coll Cardiol 1995;26:654-661.
  • 22. Rubin JB, Borden WB. Coronary heart disease in young adults. Curr Atheroscler Rep 2012;14:140-149.
  • 23. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 1995;108:364–369.
  • 24. Colkesen AY, Acil T, Demircan S, Sezgin AT, Muderrisoglu H. Coronary lesion type, location, and characteristics of acute ST elevation myocardial infarction in young adults under 35 years of age. Coron Artery Dis 2008;19:345–347.
  • 25. Yildirim N, Arat N, Dogan MS, Sokmen Y, Ozcan F. Comparison of traditional risk factors, natural history and angiographic findings between coronary heart disease patients with age or 040 years old. Anadolu Kardiyol Der 2007;7:124–127.
  • 26. Hosseini SK, Soleimani A, Karimi AA, Sadeghian S, Darabian S, Abbasi SH, et al. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMİ) in young adults under 40 years of age. Monaldi Arch Chest Dis 2009;72:71-76.
  • 27. Alizadehasl A, Sepasi F, Toufan M. Risk factors, clinical manifestations and outcome of acute myocardial infarction in young patients. J Cardiovasc Thorac Res 2010;2:29-34.
  • 28. Christus T, Shukkur AM, Rashdan I, Koshy T, Alanbaei M, Zubaid M, et al. Coronary artery disease in patients aged 35 or less- a different beast? Heart Views 2011:12(1):7-11.
  • 29. Haegeli LM, Kotschet E, Byrne J, Adam DC, Lockwood EE, Leather RA, et al. Cardiac injury after percutaneous catheter ablation for atrial fibrillation. Europace. 2008;10:273–275.
  • 30. Scharhag J, George K, Shave R, Urhausen A, Kindermann W. Exercise-associated increases in cardiac biomarkers. Med Sci Sports Exerc 2008;40:1408–1415.
  • 31. Callachan EL, Alseikh-Ali AA, Wallis LA. Analysis of risk factors, presentation, and in-hospital events of very young patients presenting with ST-elevation myocardial infarction. J Sauidi Heart Assoc 2017;29:270-275.
  • 32. Bhardwaj R, Arvind Kandoria A, Rajesh Sharma R. Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement. Niger Med J 2014; 55: 44–47.
  • 33. Gambhir JK, Kaur H, Gambhir DS, Prabhu KM. Lipoprotein(a) as an independent risk factor for coronary artery disease in patients below 40 years of age. Indian Heart J 2000;52(4): 411–415.
  • 34. Davidson L, Wilxon J, Kim D, Benton S, Fredi J, Vaughan D. Clinical features of precocious acute coronary syndrome. Am J Med 2014;127:140-144.
  • 35. Cole JH, Miller 3rd JI, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. J Am Coll Cardiol 2003;41:521-528.
  • 36. Barbash GI, White HD, Modan M, Diaz R, Hampton JR, Heikkila J, 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;16:313–316.

Gençlerde Revaskülarizasyon Gerektiren Koroner Arter Hastalığı Risk Faktörleri ve Anjiyografik Özellikleri: Tek Merkez Deneyimi

Yıl 2019, , 59 - 72, 30.06.2019
https://doi.org/10.33716/bmedj.537719

Öz

Kardiyovasküler hastalık (KVH) en sık ölüm ve morbidite
nedenlerindendir. İleri yaş aterosklerozun ilerlemesinde en önemli risk
faktörlerinden biridir. Koroner arter hastalığı (KAH) genellikle erkeklerde 45
yaşın ve kadın popülasyonda 55 yaş üstünde görülür. Bununla birlikte, genç
popülasyonda miyokard enfarktüsünün (MI) prevalansında önemli bir artış vardır.
Bu çalışmanın amacı, kalp şikayetleri ile başvuran ve koroner anjiyografi (KAG)
yapılan genç popülasyonda KAH için en yaygın risk faktörlerini tanımlamak ve
tedavi stratejileri ile birlikte birincil ve ikincil önleme stratejilerini
belirlemektir. Metod: Son 10 yıl içinde kardiyak şikayetlerle gelerek KAG
yapılmış genç hastalar geriye dönük olarak tarandı. Çalışmaya toplam 113 olgu
alındı.  Revaskülarizasyon ihtiyaçlarına
göre iki ana gruba ayrıldı. KAG sonrası koroner revaskülarizasyon gerektirmeyen
olgular kontrol, ​​(Grup 1); Koroner revaskülarizasyon ihtiyacı olanlar ise
hasta grubu (Grup 2) şeklinde sınıflandırıldı. İstatistiksel analiz için SPSS
15.0 for Windows programı kullanıldı. Kategorik değişkenler için tanımlayıcı
istatistikler; sayı ve yüzde olarak ifade edildi. Sayısal değişkenler için
tanımlayıcı istatistikler; ortalama, standart sapma, minimum, maksimum, medyan
şeklinde ifade edildi. İki değişkenli bağımsız değişkenlerin sayısal
dağılımları normal dağılım koşulu sağladığında, Student t testi, normal dağılım
koşulu sağlanamadığında Mann-Whitney U testi yapıldı. Bağımsız gruplardaki
oranlar Ki kare testi ile karşılaştırıldı. Alfa'nın istatistiksel anlamlılık
düzeyi p
<0,05 olarak kabul edildi. Sonuç: Erkek cinsiyet
prevalansı, gruplar arasında kadın cinsiyetten anlamlı olarak daha yüksekti
(p=0.002). BKİ'nin ortalama değerinde gruplar arasında istatistiksel olarak
anlamlı bir fark yoktu (p=0.105). Sigara ve ortalama sigara sayısı Grup 2'de
anlamlı derecede yüksekti (p
<0.001; p=0.002).
İlave komorbiditeler açısından gruplar arasında istatistiksel olarak anlamlı
bir fark yoktu.

Kaynakça

  • 1. Roth GA, Huffman MD, Moran AE, Feigin V, Mensah GA, Naghavi M, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation 2015;132:1667–1678.
  • 2. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129: 49–73.
  • 3. Hong MK, Cho SY, Hong BK, Chang KJ, Chung IM, Lee MH, et al. Acute myocardial infarction in young adults. Yonsei Med J 1994;35:184-189.
  • 4. Jneid H, Fonarrow GC, Cannon CP, Hernandez AF, Palacios IF, Maree AO, et al. Sex differences in medical care and early death after acute myocardial infarction. Circulation 2008:118;2803-2810.
  • 5. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. Int J Cardiol 2011;148: 300–304.
  • 6. Singh A, Collins BA, GuptaA, Fatima A, Qamar A, Biery D, et al. . Cardiovascular risk and statin eligibility of young adults after an MI. JACC 2018;3: 292-302.
  • 7. Matsis K, Holley A, Al-Sinan A, Matsis P, Larsen PD, Harding SA, et al. Differing clinical characteristics between young and older patients presenting with myocardial infarction Circulation 2017;26:566-571.
  • 8. Bostom AG, Cupples LA, Jenner JL, Ordovas JM, Seman LJ, Wilson PW, et al. Elevated plasma lipoprotein (a) and coronary heart disease in men aged 55 years and younger. A prospective study. JAMA 1996;276: 544–548.
  • 9. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndroms in young patients: Presentation , treatment and outcome. Int J Cardiol 2011;148(3):300-304.
  • 10. Malik FTN, Kalimuddin , Ahmed N, Badiuzzzaman M, Ahmed MN, Dutta A , et al. AMI in young(aged<35 years) Bangladeshi patients: Risk factors & coronary angiographic profile. Clin Trials Regul Sci Cardiol 2016; 13:1-5.
  • 11. Feijó IP, Schmidt MM, David RB, Martins JMP, Schmidt KE, Gottschall CAM, et al. Clinical profile and outcomes of primary percutaneous coronary intervention in young patients. Rev Bras Cardiol Invasiva 2015;23:48-51.
  • 12. Beraldo de Andradea P, Rinaldia FS, Ribeiro de Castro Bienerta I, Barbosaa RA, Bergonsoa MH, Brasil de Matosa MP, et al. Clinical and angiographic profile of young patients undergoing primary percutaneous coronary intervention. Rev Bras Cardiol Invasiva 2015;23(2):91-95.
  • 13. Hoit BD, Gllipin EA, Henning H, Maisel AA, Dittrich H, Carlise J, et al. Myocardial infarction in young patients: an analysis by age subset. Circulation 1986;74:712-21.
  • 14. Oliveira A, Barros H, Maciel MJ, Lopes C. Tobacco smoking and acute myocardial infarction in young adults: a population-based case–control study. Prev Med 2007;44:311–316.
  • 15. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. Int J Cardiol 2011;148:300–304.
  • 16. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 1995;108:364-369.
  • 17. Tungsubutra W, Tresukosol D, Buddhari W, Boonsom W, Sanguanwang S, Srichaiveth B. Acute coronary syndrom in young adults: Thai ACS Registry. J Med Assoc Thai 2007 Oct:90 suppl 1:81-90.
  • 18. B Chandrasekaran, A S Kurbaan. Myocardial infarction with angiographically normal coronary arteries.JR Soc Med 2002;95: 398–400.
  • 19. Konishi H, Miyauchi K, Kasai T, Tsuboi S, Ogita M, Naito R, et al. Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention. J Cardiol 2014;64:171-174.
  • 20. Canto JG, Rogers WJ, Goldberg RJ, Peterson ED, Wenger NK, Vaccarino V, et al.Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012;307:813–822.
  • 21. Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry).J Am Coll Cardiol 1995;26:654-661.
  • 22. Rubin JB, Borden WB. Coronary heart disease in young adults. Curr Atheroscler Rep 2012;14:140-149.
  • 23. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest 1995;108:364–369.
  • 24. Colkesen AY, Acil T, Demircan S, Sezgin AT, Muderrisoglu H. Coronary lesion type, location, and characteristics of acute ST elevation myocardial infarction in young adults under 35 years of age. Coron Artery Dis 2008;19:345–347.
  • 25. Yildirim N, Arat N, Dogan MS, Sokmen Y, Ozcan F. Comparison of traditional risk factors, natural history and angiographic findings between coronary heart disease patients with age or 040 years old. Anadolu Kardiyol Der 2007;7:124–127.
  • 26. Hosseini SK, Soleimani A, Karimi AA, Sadeghian S, Darabian S, Abbasi SH, et al. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMİ) in young adults under 40 years of age. Monaldi Arch Chest Dis 2009;72:71-76.
  • 27. Alizadehasl A, Sepasi F, Toufan M. Risk factors, clinical manifestations and outcome of acute myocardial infarction in young patients. J Cardiovasc Thorac Res 2010;2:29-34.
  • 28. Christus T, Shukkur AM, Rashdan I, Koshy T, Alanbaei M, Zubaid M, et al. Coronary artery disease in patients aged 35 or less- a different beast? Heart Views 2011:12(1):7-11.
  • 29. Haegeli LM, Kotschet E, Byrne J, Adam DC, Lockwood EE, Leather RA, et al. Cardiac injury after percutaneous catheter ablation for atrial fibrillation. Europace. 2008;10:273–275.
  • 30. Scharhag J, George K, Shave R, Urhausen A, Kindermann W. Exercise-associated increases in cardiac biomarkers. Med Sci Sports Exerc 2008;40:1408–1415.
  • 31. Callachan EL, Alseikh-Ali AA, Wallis LA. Analysis of risk factors, presentation, and in-hospital events of very young patients presenting with ST-elevation myocardial infarction. J Sauidi Heart Assoc 2017;29:270-275.
  • 32. Bhardwaj R, Arvind Kandoria A, Rajesh Sharma R. Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement. Niger Med J 2014; 55: 44–47.
  • 33. Gambhir JK, Kaur H, Gambhir DS, Prabhu KM. Lipoprotein(a) as an independent risk factor for coronary artery disease in patients below 40 years of age. Indian Heart J 2000;52(4): 411–415.
  • 34. Davidson L, Wilxon J, Kim D, Benton S, Fredi J, Vaughan D. Clinical features of precocious acute coronary syndrome. Am J Med 2014;127:140-144.
  • 35. Cole JH, Miller 3rd JI, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. J Am Coll Cardiol 2003;41:521-528.
  • 36. Barbash GI, White HD, Modan M, Diaz R, Hampton JR, Heikkila J, 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;16:313–316.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Flora Özkalaycı 0000-0003-2816-0199

Öykü Gülmez Bu kişi benim 0000-0002-9429-5430

Armağan Altun 0000-0002-3233-8263

Yayımlanma Tarihi 30 Haziran 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

APA Özkalaycı, F., Gülmez, Ö., & Altun, A. (2019). Risk Factors and Angiographic Characteristics of Coronary Artery Disease Requiring Revascularisation In Young Adults: A Single Centre Experience. Balıkesir Medical Journal, 3(2), 59-72. https://doi.org/10.33716/bmedj.537719