Predictive Factors of Major Adverse Cardiac Events and Clinical Outcomes of Acute Myocardial Infarction in Young Korean Patients
Korean Circulation Journal
;
: 161-169, 2008.
Artigo
em Coreano
| WPRIM
| ID: wpr-7155
ABSTRACT
BACKGROUND AND OBJECTIVES:
Acute myocardial infarction (AMI) occurring in patients at a young age (40 years or younger) is an uncommon condition and is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of young-aged Korean AMI patients (age of 40 years or younger) and other AMI patients, who were registered in the Korea Acute Myocardial Infarction Registry (KAMIR) for one year. SUBJECTS ANDMETHODS:
In 2006, 8,565 patients (mean age 64.4+/-12.7 years; 5,591 males) were registered in the KAMIR. The patients were divided into two groups Group I (younger patients 40 years; n=8,304, mean age 65.4+/-11.8 years; 5,330 males). The clinical and angiographic characteristics and major adverse cardiac events (MACE) were compared for the two groups of patients.RESULTS:
The baseline clinical characteristics of gender, age, risk factors (hypertension, smoking, diabetes, familial history) and body weight were different between the two groups (p<0.001). The baseline echocardiographic and laboratory findings of the initial ejection fraction, and the glomerular filtration rate, level of creatine kinase (CK), level of CK-MB isoenzyme, total cholesterol level, triglyceride level, and N-terminal prohormone brain natriuretic peptide (NT-proBNP) level were different between the two groups (p< or =0.001). According to the use of multiple logistic regression analysis, use of thrombolysis [p=0.009, adjusted hazard ratio (aHR)=9.140, 95% confidence interval (CI) 1.727-48.383], a high blood glucose level (p=0.029, aHR=1.008, 95% CI 1.001-1.016), a low body mass index (<25 kg/m(2), p=0.031, aHR=6.236, 95% CI 1.183-32.857), and a high CK-MB level and high Thrombolysis in Myocardial Infarction (TIMI) risk score were independent predictors of MACE at 1 year after an AMI in young age patients. Early clinical outcomes were better in Group I than in Group II patients, but one-, six- and twelve-month MACE were not different between the two groups.CONCLUSION:
The independent predictors of MACE at 1 year in young age AMI patients were the use of thrombolysis, a high blood glucose level, a low body mass index, a high CK-MB level and a high TIMI risk score. Patients that have had an acute myocardial infarction at a young age have a better early clinical outcome, but the long-term clinical outcomes were not different compared with older patients, and thus long-term intensive medical therapy will be required, even in young AMI patients.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Prognóstico
/
Fumaça
/
Glicemia
/
Peso Corporal
/
Fumar
/
Índice de Massa Corporal
/
Modelos Logísticos
/
Colesterol
/
Fatores de Risco
/
Idade de Início
Tipo de estudo:
Estudo de etiologia
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Coreano
Revista:
Korean Circulation Journal
Ano de publicação:
2008
Tipo de documento:
Artigo
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