Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Abstract

AIM:To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore. METHODS:Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes. RESULTS:The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and highdensity lipoprotein levels were 5.6 ± 1.2 mmol/L, 3.8 ± 1.1 mmol/L and 0.93 ± 0.25 mmol/L respectively. The mean left ventricular function was 44% ± 10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups. CONCLUSION:Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI.

Acute ST-Elevation Myocardial Infarction in Young in Shahid Gangalal National Heart Centre, Kathmandu, Nepal

“…These findings are inconcordance with most of the recent studies. 7,14,15 In our study, the most common complication in young STEMI patients was arrhythmias (5.3%) followed by cardiogenic shock (4.5%) and heart failure, 3,6 which was similar to the study by Wong et al, 12 in which the most common complication was arrhythmias (7.2%) followed by cardiogenic shock (4.5%).…”

“…7,8,9,10,11 In our study, mean age of presentation was 39.14 years, which was in similar range with that to some recent studies done in Asian population. As studies done by Wong et al, 12 and Al Khadra et al, 13 showed mean age of 39.9, and 40 years. Our study showed 6.8% of patients were younger than 30 years which were slightly higher than few recent This may be the sign of increasing trend of young patients developing CAD.…”

Prognostic Factors for In-Hospital and Long-Term Survival in Patients with Acute ST-Segment Elevation Myocardial Infarction after Percutaneous Coronary Intervention

“…Acute myocardial infarction (AMI) refers to the drastically reduced or interrupted blood supply of the coronary arteries, leading to myocardial ischemia (Wong et al 2012). It is characterized by dull chest pain, arrhythmia, shock and heart failure (Boateng and Sanborn 2013).…”

Study on emerging risk factors of acute myocardial infarction patients in Kumaon region of Uttarakhand, India

“…6 Their mean age at presentation was 39.9±4.2 years in Indian population. In the overall study group, the mean age at presentation was 40.2±4.0 years (range 25 to 45 years) with a male predominance (94%).…”

“…8 Pong C found in their study that the mean BMI was 26.1±3.8 kg/m 2 with 37% of young adults considered obese by Asian BMI criteria. 6 Cigarette smoking was identified as a major risk factor in 138 (46%) patients. The least common risk factor i.e.…”