Clinical Outcomes and Risk Factor in Patients with STEMI Treated with Percutaneous Coronary Intervention

Abstract

This study was carried out to analyze risk factors and short-term clinical outcomes in different age groups of Indian patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention. This prospective, non-randomized, and observational study was carried out at a tertiary care hospital. The patients who were treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction at study center from December 2011 to September 2012 were included in the study. Study population is divided into three groups: Group-I consisted of patients with age ≤ 40 years, Group-II consisted of patients with age between 41 -60 years and Group-III consisted of patients with age > 60 years. The primary end-point of the study was occurrence of major adverse clinical outcomes which were a composite of death, reinfarct, repeat percutaneous coronary intervention, major bleeding and emergency coronary artery bypass grafting at 30-day follow-up. A total of 200 patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention were included in the study. Among study population, 10 (5%) patients constituted Group-I, 96 (48%) patients constituted Group-II and 94 (47%) patients constituted Group-III. Diabetes (0% vs. 35.4% vs. 43.6%) and hypertension (10% vs. 35.4% vs. 44.7%) were more prevalent in Group-III as compared to Group-II and Group-I. The prevalence of single vessel disease was significantly higher in the Group-I compared to Group-II and Group-III (80% vs. 41.66% vs. 17%). At 30-day clinical follow-up, the rate of occurrence of major adverse clinical outcomes in Group-I, Group-II and Group-III is 0%, 2% and 5.4%, respectively. The young ST-elevation myocardial infarction patients had lower incidences of diabetes and hypertension compared with elderly patients. The young age group had more favorable inhospital and 30-day clinical outcomes.

Clinical characteristics and prognosis of young middle Eastern adults with ST-elevation myocardial infarction: One-year follow-up

“…Although our sample size is not very large, it is still among the largest reports of STEMI in young patients in the Middle East. And, unlike other published reports of myocardial infarction in young adults in developing countries,[ 11 12 36 ] our study was a multicenter study that followed patients prospectively for one year.…”

“…This is in line with other reports from developing countries where 80% of the young (≤40) STEMI patients from Kannur, India and 62% of the young (<40 years) STEMI patients from Abu Dhabi, UAE had single-vessel disease. [ 5 12 ]…”

“…[ 9 ] Cigarette smoking, family history of premature coronary artery disease (CAD), male gender, obesity, hypertension, Type 2 diabetes mellitus, and dyslipidemia, which are the usual atherosclerosis risk factors, have also been identified as significant differential risk factors in the etiology of premature MI. [ 8 10 11 12 ]…”

“…[ 8 11 ] The differential clinical characteristics of young patients with STEMI compared with older patients has been the focus of few studies. [ 11 12 ] Our aim is to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI.…”

Predictors of Multivessel Coronary Artery Disease in Young Patients Presenting With St-Segment Elevation Myocardial Infarction

“…1,2 Several studies have reported a 1-16% prevalence of AMI in young populations. [1][2][3][4][5][6][7][8] Several causes and risk factors for premature MI have been highlighted, including mental stress, excessive workload, smoking, sedentary lifestyle, unhealthy dietary habits, and addiction. 2,6 Although AMI in young individuals has a relatively better prognosis, [9][10][11] its social and economic burden is critical for both family and society during the productive years of life.…”