COMMON RISK FACTORS INVOLVED IN THE DEVELOPMENT OF MYOCARDIAL INFARCTION IN ADULTS YOUNGER THAN 45 YEARS OF AGE
Keywords:Myocardial Infarction, Smoking, Hypertension, Mortality, Prognosis, Prevention, Ischemic heart disease
AbstractBackground: Pakistan has got a very high prevalence of myocardial infarction (MI). MI presents at pretty young age in this country. The objective of present study was to determine the frequency of common risk factors associated with early development of MI in middle aged adults of less than 45 years. Methods: It was a cross sectional study conducted in the Cardiology department of Ayub Teaching Hospital (ATH) Abbottabad from 23rd June 2015 – 10th July 2016. A total of 255 consecutive patients diagnosed with MI admitted to the Cardiology Unit of ATH, Abbottabad. A detailed medical history and general physical examination of the patients was carried out with an emphasis on recording the presence or absence of common risk factors of MI in these patients. All routine investigations (Blood Complete Picture, Urea, Creatinine, Blood Sugar & Lipid Profile) were done. Results: Mean age of the subjects was 39.98±4.61 SD. The frequency of risk factors in descending order was smoking in (38.8%), obesity in (29.4%) and essential hypertension in (21.6%) of the patients. Other risk factors of MI in this study were diabetes mellitus (19.2%), family history of ischemic heart disease (IHD) was (18.8%) and disproportionate dyslipidemias in (12.9%). Sex of patients (male predominance) was found to be significantly associated with diabetes, smoking and dyslipidemia (p<0.05). Conclusion: Male sex, smoking, hypertension and obesity confer an increased risk of myocardial infarction in patients younger than 45 years of age.
Jamil G, Jamil M, Alkhazraji H, Haque A, Chedid F, Balasubramanian M, et al. Risk factor assessment of young patients with acute myocardial infarction. Am J Cardiovasc Dis 2013;3(3):170–4.
Beltrame JF, Dreyer R, Tavella R. Epidemiology of coronary artery disease [Internet]. INTECH Open Access Publisher; 2012 [cited 2016 Jul 17]. Available from: www.intechopen.com/download/pdf/32288
Iqbal MA, Rauf MA, Faheem M, Shah I, Khan N, Khan SB, et al. Comparison of in-hospital outcome of acute inferior myocardial infarction complicated by right ventricular infarction with isolated acute inferior myocardial infarction. Pak Heart J 2013;45(4):225–30.
Ullah I, Ali J, Faheem M, Qureshi S, Shah SFA, Khan SA, et al. Frequency of complete heart block and in-hospital mortality in patients with acuteac anterior wall myocardial infarction. Pak Heart J 2013;45(4):249–55.
Yunyun W, Tong L, Yingwu L, Bojiang L, Yu W, Xiaomin H, et al. Analysis of risk factors of ST-segment elevation myocardial infarction in young patients. BMC Cardiovasc Disord 2014;14(1):179.
Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJL, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: The Global Burden of Disease 2010 study. Circulation 2014;129(14):1483–92.
Iqbal MA, Hadi A, Farooq M, Khan N, Wahid I, Hafizullah M. Frequency of conventional risk factors among coronory artery disease patients in tribal area of Pakistan. Pak Heart J 2014;47(3):132–6.
Islam F, Khan A, Naz S, Said AB. Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients Admitted to Tertiary Care Hospitals of Peshawar. Int J Innov Res Devel 2015;4(5):8–11.
Incalcaterra E, Caruso M, Lo Presti R. Myocardial infarction in young adults: risk factors, clinical characteristics and prognosis according to our experience. Clin Ter 2013;164(2):e77–82.
Pineda J, Marín F, Roldán V, Valencia J, Marco P, Sogorb F. Premature myocardial infarction: clinical profile and angiographic findings. Int J Cardiol 2008;126(1):127–9.
Anderson RE, Pfeffer MA, Thune JJ, McMurray JJV, Califf RM, Velazquez E, et al. High-risk myocardial infarction in the young: the VAL sartan in Acute myocardial iNfarcTion (VALIANT) trial. Am Heart J 2008;155(4):706–11.
Gaeta G, De Michele M, Cuomo S, Guarini P, Foglia MC, Bond MG, et al. Arterial abnormalities in the offspring of patients with premature myocardial infarction. N Engl J Med 2000;343(12):840–6.
Topol EJ, McCarthy J, Gabriel S, Moliterno DJ, Rogers WJ, Newby LK, et al. Single nucleotide polymorphisms in multiple novel thrombospondin genes may be associated with familial premature myocardial infarction. Circulation 2001;104(22):2641–4.
Park C, Guallar E, Linton JA, Lee DC, Jang Y, Son DK, et al. Fasting Glucose Level and the Risk of Incident Atherosclerotic Cardiovascular Diseases. Diabetes Care 2013;36(7):1988–93.
Wong CP. Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore. World J Cardiol 2012;4(6):206–10.
Dreyer RP, Wang Y, Strait KM, Lorenze NP, D’Onofrio G, Bueno H, et al. Gender differences in the trajectory of recovery in health status among young patients with acute myocardial infarction: results from the variation in recovery: role of gender on outcomes of young AMI patients (VIRGO) study. Circulation 2015;131(22):1971–80.
Johnson BD, Shaw LJ, Buchthal SD, Bairey Merz CN, Kim HW, Scott KN, et al. Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease: results from the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE). Circulation 2004;109(24):2993–9.
Hamelin BA, Méthot J, Arsenault M, Pilote S, Poirier P, Plante S, et al. Influence of the menstrual cycle on the timing of acute coronary events in premenopausal women. Am J Med 2003;114(7):599–602.