40 Yaş ve Altı Akut Koroner Sendrom Hastalarında Risk Faktörleri

Abstract

Amaç: Bu çalışmada akut koroner sendromlu (AKS) genç erişkin hastaların (<40 yaş) klinik ve demografik özelliklerini ve risk faktörlerini analiz etmeyi amaçladık. Uygulanan tedavi yöntemleri ile cinsiyet faktörünün klinik farklılıkları ve sonuçları. Gereç ve Yöntemler: Bu retrospektif çalışmaya 2016-2020 yılları arasında Bursa şehrindeki bir hastanede akut koroner sendrom nedeniyle tedavi edilen 40 yaş ve altındaki hastalar dahil edildi. Bulgular: Çalışmaya toplam 63 hasta (%7,4) dâhil edildi. Hastaların çoğunluğu erkekti (%78) ve ortanca yaş 38 idi. Sigara kullanımı erkeklerde kadınlara göre anlamlı derecede daha yaygındı (%97,9'a karşı %42,8, p<0.001). Erkeklerde kreatinin (0,81±0,13 vs. 0,69±0,08 mg/dL, p=0,010) ve hemoglobin düzeyleri (15±1,3 vs. 11,7±1,6 g/dL, p<0,001) daha yüksekken, kadınlarda RDW (%14 vs. %13, p=0,020) ve trombosit sayıları (350±82 vs. 282±63 ×10³/µL, p=0,010) daha yüksekti. Hiperlipidemi stent grubunda (%72) KABG (%41,2) ve medikal gruplara (%10) kıyasla daha sıktı (p=0.006). Kararsız anjina KABG hastalarında (%58,9) ve STEMI stent hastalarında (%52,9) daha yaygındı (p=0,005 ve p=0,040). Glukoz ve troponin düzeyleri sırasıyla medikal ve stent gruplarında daha yüksekti (her ikisi için de p=0,020). HDL medikal grupta daha yüksekti (46±4 mg/dL, p=0.020). Sonuç: Bu çalışmada tanımlanan risk faktörleri ve biyokimyasal parametrelerdeki cinsiyet ve tedaviye bağlı farklılıklar, koroner arter hastalığında bireyselleştirilmiş risk değerlendirmesini destekleyebilir. Özellikle, erkeklerdeki yüksek sigara içme oranları ve kadınlardaki farklı hematolojik özellikler klinik değerlendirmede dikkate alınmalıdır.

Keywords

• Akut koroner sendrom
• genç erişkin
• cinsiyet faktörü
• risk faktörleri

Ethical Statement

Çalışma için yerel etik kurulundan onay alınmıştır (Tarih: 03.09.2024, Karar no: 2024-04).

The Risk Factors in Patients 40 Years and Under with Acute Coronary Syndrome

Abstract

Aim: In this study, we aimed to analyze the clinical and demographic characteristics and risk factors of young adult patients (aged <40 years) with acute coronary syndrome (ACS). Clinical differences and outcomes related to the sex factor with the treatment modalities applied. Material and Methods: This retrospective study included patients aged 40 years and younger who were treated for acute coronary syndrome in a hospital in Bursa between 2016 and 2020. Results: A total of 63 patients (7.4%) were included in the study. The majority of the patients were male (78%) and the median age was 38 years. Smoking was significantly more common in males than females (97.9% vs. 42.8%, p<0.001). Males had higher creatinine (0.81±0.13 vs. 0.69±0.08 mg/dL, p=0.010) and hemoglobin levels (15±1.3 vs. 11.7±1.6 g/dL, p<0.001), while females had higher RDW (14% vs. 13%, p=0.020) and platelet counts (350±82 vs. 282±63 ×10³/µL, p=0.010). Hyperlipidemia was more frequent in the stent group (72%) compared to CABG (41.2%) and medical groups (10%) (p=0.006). Unstable angina was more common in CABG patients (58.9%), and STEMI in patients with stents (52.9%) (p=0.005 and p=0.040). Glucose and troponin levels were higher in the medical and stent groups, respectively (p=0.020 for both). HDL was higher in the medical group (46±4 mg/dL, p=0.020). Conclusion: The gender- and treatment-related differences in risk factors and biochemical parameters identified in this study may support individualized risk assessment in coronary artery disease. Notably, high smoking rates in males and distinct hematologic features in females merit attention in clinical evaluation.

Keywords

• Acute coronary syndrome
• young adult
• sex factors
• risk factors

Ethical Statement

Approval for the study was obtained from the local ethics committee (Date: 03.09.2024, Decision no: 2024-04).

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