Clinical and coronary angiographic profiling in young patient with acute ST-elevation myocardial infarction admitted in cardiac critical care unit of tertiary care centre at south Tamil Nadu
Keywords:STEMI, Angiography, Percutaneous coronary intervention
Background: Premature coronary artery disease (PCAD) is associated with a high rate of ischemic recurrence and mortality, causing a significant impact on public health. The present study focuses on the assessment of the risk factors, clinical presentation, angiographic profiling considering severity, and management of extremely young adults (aged ≤45 years) affected with first ST elevation acute myocardial infarction (STEMI).
Methods: The current study (cross-section) was carried out among 94 consecutive patients with STEMI. The study on patients was carried out between January 2022 and June 2022 at Tirunelveli Medical College Hospital, department of cardiology.
Results: This study involved 94 patients with a mean age of 37.80 years, 8.5% <25, and 84.9% male patients. Risk factors included smoking, being overweight, diabetes, hypertension, chest pain, syncope, and obstructive coronary artery disease (CAD). The most common symptom was chest pain (98.9%). Left anterior descending (LAD) was the most common culprit artery (26.1%), and ostial LAD was (3.2%). Percutaneous coronary intervention (PCI) was done in 53.2% of patients, elective PCI was 26.6%, pharma co-invasive PCI was 24.5%, and primary PCI was 2.1%. The patient was referred to coronary artery bypass grafting was 10.6%. 23.4% of patients had recanalized and normal coronaries, and 36% received medical management. No mortality occurred in this study.
Conclusions: Most commonly, AMI is found in very young male adults, and smoking is the commonly associated risk factor. LAD artery involvement was the leading cause of AWMI and the most common presentation observed.
Suresh G, Subramanyam K, Kudva S, Saya RP. Coronary artery disease in young adults: Angiographic study- A single-centre experience. Heart India. 2016;4:132.
Prakash B, Jaiswal A, Shah MM. Demographic & angiographic profile of young patients aged 40 years & less undergoing coronary angiography in a tier II city of Eastern India. J Family Med Prim Care. 2020;9:5183-7.
Abderrahman HA, Al-Abdallat IM, Idhair AK. Age threshold for a proper definition of premature coronary artery disease in males. J Forensic Leg Med. 2018;58:45-9.
Malakar A, Jyoti Bhattacharyya P, Chandra Barkataki J, Thakuria S. Clinical and angiographic profile of coronary artery disease in young women - a tertiary care centre study from North Eastern India. Int J Adv Res. 2022;10:614-26.
Maroszyńska-Dmoch EM, Wozakowska-Kapłon B. Clinical and angiographic characteristics of coronary artery disease in young adults: A single centre study. Kardiol Pol. 2016;74:314-21.
Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, et al. Acute myocardial infarction in the young - The University of Michigan experience. Am Heart J. 2002;143:56-62.
Zeitouni M, Clare RM, Chiswell K, Abdulrahim J, Shah N, Pagidipati NP, et al. Risk factor burden and long-term prognosis of patients with premature coronary artery disease. J Am Heart Assoc. 2020;9:e017712.
Jneid H, Fonarow 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;118:2803-10.
Takagi Y, Yasuda S, Tsunoda R, Ogata Y, Seki A, Sumiyoshi T, et al. Clinical characteristics and long-term prognosis of vasospastic angina patients who survived out-of-hospital cardiac arrest: Multicenter registry study of the Japanese Coronary Spasm Association. Circ Arrhythm Electrophysiol. 2011;4:295-302.
Swain L, Routray PN. Demographic and clinic-angiographic profile of coronary artery disease in young adults: a retrospective observational study. Int J Res Med Sci. 2018;6:2264.
Younis YS, Ali AH, Alhafidhb OKS, Yahia WB, Alazzam MB, Hamad AA, et al. Early diagnosis of breast cancer using image processing techniques. J Nanomater. 2022;1-6.
Pitso L, Mofokeng TRP, Nel R. Dyslipidaemia pattern and prevalence among type 2 diabetes mellitus patients on lipid-lowering therapy at a tertiary hospital in central South Africa. BMC Endocr Disord. 2021; 21:159.
Muhammad A, Nizam A, Yousuf MH, Kamran H. Angiographic severity of CAD in patients with acute coronary syndrome in correlation to their glycemic status. Pakistan J Med Heal Sci. 2019;13:312-6.
Jortveit J, Pripp AH, Langørgen J, Halvorsen S. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart. 2020;106:1420-6.
Parkar M, Chavan C, Pawar S, Chavan Y. Angiographic profile of coronary artery disease in patients with acute coronary syndrome in correlation to their glycaemic status. Int J Adv Med. 2021;8:781.