Keywords
Young people
Elderly people
Risk factors
Submitted : 2024-06-18
Accepted : 2024-07-03
Published : 2024-07-18
Abstract
Objective: To investigate the differences in risk factors and prognosis between young and elderly patients with acute ST-segment elevation myocardial infarction (STEMI) to provide a basis for the prevention of young patients with acute STEMI. Methods: Patients initially diagnosed with STEMI in the 920th Hospital of Joint Logistic Support Force of PLA from January 1, 2018, to December 31, 2022, were retrospectively enrolled in this study. A total of 235 STEMI patients aged ≤ 45 years old and 532 STEMI patients aged ≥ 65 years old were screened. The baseline characteristics, laboratory indicators, clinical characteristics, coronary angiography, SYNTAX score, and major adverse cardiovascular events (MACE) during 1-year follow-up were analyzed and compared. Results: A total of 767 STEMI patients were enrolled, including 235 in the young group and 532 in the elderly group. Among the STEM patients in the young group, 224 cases were male, and smoking and drinking were common. Compared with the elderly group, the young group had shorter hospital stays and more of them had a family history of ischemic heart disease (IHD). The level of low-density lipoprotein in the young group was higher than that in the old group, while the level of high-density lipoprotein in the young group was lower than that in the old group. The level of high uric acid and homocysteine in the young group was significantly higher than that in the elderly group. The main cause of STEMI in the young group was fatigue, and the most common symptom was angina pectoris. Coronary angiography showed that single vessel disease was more common in the young group than in the elderly group, and the lesion in the young group was the left anterior descending artery. The SYNTAX score was significantly lower in the young group than in the elderly group according to the anatomical characteristics of coronary artery disease. In the forest plot, diabetes mellitus and a family history of IHD showed a trend of major adverse cardiovascular events (MACE) in both groups. Conclusion: Males, smokers, alcohol drinkers, and family history of ischemic heart disease are more common among young patients. Common risk factors include fatigue, hyperuricemia, hyperlipidemia, and so on. In addition, age itself is an independent risk factor. Management of diabetes, hyperuricemia, and homocysteine levels is essential to reduce the incidence of cardiovascular events in young patients. By controlling these factors, the incidence of young patients with acute STEMI can be effectively prevented and the corresponding prevention and treatment basis can be provided.
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