Clinical features and long-term prognosis of patients suffering from myocardial infarction with premature st segment elevation / 解放军医学杂志

ABSTRACT

Objective To investigate the risk factors, clinical features and prognosis of premature ST-segment elevation myocardial infarction (STEMI). Methods In this retrospective analysis, 1428 patients who were diagnosed as premature STEMI (male ≤55 years old, female ≤65) and treated with percutaneous coronary intervention (PCI), admitted to General Hospital of Shenyang Command from July 2008 to November 2012, were divided into two groups, namely the young (≤45 years old, n=381) and middle aged (>45 years old, n=1047) groups. Clinical characteristics and prognosis of the premature STEMI patients in different age groups were summarized and compared. Results The percentage of male (97.1% vs 76.7%, P<0.01), smokers (76.9% vs 65.7%, P<0.001), overweight (70.3% vs 64.9%, P=0.014), hyperlipidemia (53.3% vs 44.6%, P=0.004) were significant higher in young patients than in middle aged patients. Higher proportions of morbidities, such as hypertension (35.4% vs 43.6%, P=0.005), diabetes (14.7% vs 23.9%, P<0.001), renal insufficiency (3.4% vs 8.5%, P=0.001) and stroke (1.6% vs 5.3%, P=0.002) were found in middle aged than young patients. The incidence of multi-vessel disease was lower in young patients (47.5% vs 63.6%, P<0.001). Young patients were associated with a significantly decreased 3-year incidence of major adverse cardiovascular events compared with middle aged patients (7.1% vs 4.8%, P=0.04). Conclusion Young patients with premature STEMI is associated with less comorbidities but more controllable risk factors and worse long-term prognosis than middle aged counterparts.