ARYA Atherosclerosis Journal

Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India - AMIYA Study

Document Type : Original Article(s)

Authors

Santosh Kumar Sinha 1
Vinay Krishna 1
Ramesh Thakur 2
Ashutosh Kumar 3
Vikas Mishra 4
Mukesh Jitendra Jha 4
Karandeep Singh 4
Mohit Sachan 4
Rupesh Sinha 4
Mohammad Asif 4
Nasar Afdaali 4
Chandra Mohan Varma 2

1 Assistant Professor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India

2 Professor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India

3 Senior Researcher, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India

4 Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India

Abstract
BACKGROUND: India is currently in the fourth stage of epidemiological transitions where cardiovascular disease is the leading cause of mortality and morbidity. Purpose of the present study was to assess the risk factors, clinical presentation, angiographic profile including severity, and in-hospital outcome of very young adults (aged ≤ 30 years) with first acute myocardial infarction (AMI). METHODS: Total of 1,116 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) were studied between March 2013 and February 2015 at LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India. RESULTS: Mean age of the patients was 26.3 years. Risk factors were smoking (78.5%), family history of premature coronary artery disease (CAD) (46.8%), obesity (39.1%), physical inactivity (38.7%) and stressful life events (29.6%). The most common symptom and presentation was chest pain and anterior wall MI (AWMI) in 94.8% and 58.8%, respectively. About 80.6% of patients had obstructive CAD with single vessel disease (57.6%), double-vessel disease (12.9%) and left main involvement (3.2%). Left anterior descending (LAD) was commonest culprit artery (58.1%) followed by right coronary artery in 28.2%. In-hospital mortality was 2.8%. Percutaneous coronary intervention was performed in 71.6% of patients. Median number and length of stent were 1.18 and 28 ± 16 mm, respectively. CONCLUSION: AMI in very young adult occurred most commonly in male. Smoking was the most common risk factor. AWMI owing to LAD artery involvement was the most common presentation. Mean time of presentation after symptom onset was 16.9 hours. In contrast to western population, it is characterised by earlier onset, delayed presentation, more severity, diffuse disease, and more morbidity but with favourable in-hospital mortality 

Keywords

Myocardial Infarction
Angiography
Percutaneous Coronary Intervention
Young Adults
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ARYA Atherosclerosis Journal
Volume 13, Issue 2 - Serial Number 2
March and April 2017
Pages 79-87

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