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Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry).

AbstractOBJECTIVES:
This study examined the angiographic characteristics, coronary risk factors and prognosis in young men and women with a history of myocardial infarction compared with that in older patients.
BACKGROUND:
There are few data regarding myocardial infarction in young adults. It is undetermined whether the development of myocardial infarction at a young age represents a form of coronary heart disease with an adverse prognosis.
METHODS:
Of the 8,839 patients with a history of myocardial infarction in the Coronary Artery Surgery Study (CASS), there were 294 men < or = 35 years old and 210 women < or = 45 years old. Coronary anatomy, baseline characteristics and prognosis were compared in younger and older patients.
RESULTS:
Young men and women more often had angiographically normal coronary arteries, nonobstructive disease < 70% stenosis and single-vessel disease than older patients (p < 0.0001). Current smoking was more frequent in young patients (p < 0.0001). Hypertension and diabetes were more frequent in both older men and women, whereas a positive family history of premature coronary disease was significantly more prevalent only in young men. The survival rate at 7 years was improved for young men compared with that in older men (84% vs. 75%, p = 0.0094) and for young women compared with that in older women (90% vs. 77%, p = 0.0004). When multivariate analysis was applied to the data, the survival advantage for young patients remained after adjustment.
CONCLUSIONS:
Young patients with a myocardial infarction have a favorable prognosis compared with that in older patients.
AuthorsF H Zimmerman, A Cameron, L D Fisher, G Ng
JournalJournal of the American College of Cardiology (J Am Coll Cardiol) Vol. 26 Issue 3 Pg. 654-61 (Sep 1995) ISSN: 0735-1097 [Print] United States
PMID7642855 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
Topics
  • Adult
  • Age Distribution
  • Canada (epidemiology)
  • Cause of Death
  • Coronary Angiography (statistics & numerical data)
  • Coronary Disease (diagnostic imaging, epidemiology)
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction (diagnostic imaging, epidemiology)
  • Prognosis
  • Recurrence
  • Registries (statistics & numerical data)
  • Risk Factors
  • Sex Distribution
  • United States (epidemiology)

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