Coronary Arteriographic Findings in Younger Survivors of Acute Myocardial Infarction Including Those with Normal Coronary Arteries

Sheldon, William C.; Razavi, Mehdi; Lim, Yeon Jung

doi:10.1007/978-3-642-68294-0_8

Cited by 15 publications

(4 citation statements)

References 12 publications

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“…8 Angiograms of the left coronary artery in LAO hemiaxial position of a 35.year-old man (above) and a 28-year-old woman (below) 3 months and 4 months, respectively, after anteroseptal myocardial infarction, In both patients, two streaks of contrast medium in the proximal left anterior descending artery are seen, indicating recanalization of a thrombus One-vessel disease is predominant in myocardial infarction at a young age contrary to the myocardial infarction of middle and advanced ages (48,59). Findings of other authors (9,14,25,64,70) confirm this statement. Only onethird of consecutive patients under age 60 showed one-vessel disease (5).…”

Section: Discussionsupporting

confidence: 65%

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Myocardial Infarction at a Young Age (Under 40 Years)

Roskamm¹,

Gohlke²,

Stürzenhofecker³

et al. 1984

Int J Sports Med

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Coronary morphology, risk factors, long-term prognosis, and progression of coronary arteriosclerosis were investigated in 679 (649 mean and 30 women) post-infarction patients under 40 years of age. These patients represented 80% of 844 MI patients under 40 who were referred to our hospital in the years 1973-1980; 20% had refused coronary angiography; 465 patients were followed up for 1-7 years (mean 3.5 years). In 164 patients, a second coronary angiography was performed 3.8 years after the first angiogram, which was done an average 3 months after the acute episode. The main results were as follows: 8.4% of the patients had zero-vessel disease and 3.7% had a normal coronary angiogram. The majority had single-vessel disease (57.3%). The prevalence of zero-vessel disease decreased with age while that of multivessel disease increased. With increasing vessel involvement, the prevalence of hypercholesterolemia, hypertriglyceridemia, and hypertension increased. A history of smoking was equally common in patients with zero-, single-, double-, and triple-vessel disease. In women the combination of smoking and the use of oral contraceptive drugs was frequently seen. In one-quarter of the zero-vessel disease patients, the infarction occurred during unusually intense physical exercise. The statistical analysis of the survival data using the proportional hazards model (univariate analysis) showed the variables heart volume/body wt., ventricular arrhythmias, PCP at rest, PCP max, work capacity, ventricular function, and number of diseased vessels to be of prognostic importance. Multivariate analysis using this model revealed the following independent variables to be relevant to prognosis: heart volume/body wt., ventricular arrhythmias, ventricular function, and number of diseased vessels. After an average of 3.8 years since the first coronary angiography, 28.6% of the patients showed a significant progression of coronary arteriosclerosis (at least two degrees of stenosis according to the AHA classification). In the subgroup of patients with multilocular disease in the first angiogram, progression was 10 times as frequent as in a group with initial unilocular disease (34.3% vs 3.6%). Patients with progression had continued to smoke significantly more often than patients without progression (38.4%) vs 14.5%). Regression of coronary angiographic findings was significantly more frequent in the group of patients with initial unilocular disease than in those with multilocular disease in the first angiogram (28.6% vs 10.6%). Regression might be explained as recanalization and organization of a thrombus.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Discussionsupporting

confidence: 65%

“…Normal coronary arteries, or a so-called zero-vessel disease, have repeatedly been described in patients with a documented transmural myocardial infarction (6,9,20,49,53,70,76); most of these were reports of younger patients. This study shows that the prevalence of zero-vessel disease is clearly age dependent (Fig.…”

Section: Coronary Moiphologymentioning

confidence: 99%

Myocardial Infarction at a Young Age (Under 40 Years)

Roskamm¹,

Gohlke²,

Stürzenhofecker³

et al. 1984

Int J Sports Med

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“…According to the findings, current smoking is linked to myocardial infarction in young people [36]. Both the current study and prior investigations found that young patients suffering myocardial infarction outperformed elderly individuals [33,[35][36][37] ) hypertension and diabetes were shown to be more prevalent in older age groups.…”

Section: Discussionsupporting

confidence: 56%

Effect of Cigarette Smoking on Location of Infarction in Patients Presented with ST-Segment Elevation Myocardial Infarction

Sherrah

Elshekh

El-Al

et al. 2021

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Background: In an acute ST-elevation myocardial infarction, transmural myocardial ischemia causes myocardial damage or necrosis (STEMI). In order to establish myocardial ischemia damage, the current clinical definition of myocardial infarction (MI) in 2018 includes abnormal cardiac biomarkers. STEMI is linked to a greater risk of mortality in the hospital compared to non-ST segment elevation acute coronary syndromes. The study's purpose was to investigate and assess the effect of cigarette smoking on the location of infarction in people who had ST-segment elevation myocardial infarction. Methods: The present case-control research investigated 100 individuals who had a first ST segment elevation acute myocardial infarction and got split into two groups based on the smoking status: group 1 (50 patients): Group 1 (50 patients) were smokers, whereas group 2 (50 patients) were nonsmokers. Results: Smokers were significantly younger than non-smokers (53.86±7.77) years vs. (58.20 ± 7.80), P = 0. 006. Gender distribution: Smokers were significantly more likely to be male (82.0% vs. 58.0%, P = 0.009). inferior STEMI was statistically significant difference among the two groups (P value =0.045*). Myocardial Infarction Localization by electrocardiogram was statistically significant different among the two groups (P value =0.045*). Ejection fraction (EF) was statistically significant different among the two groups (smoker and nonsmokers respectively 54.86 ± 8.58% vs. 49.04 ± 6.61%) (P value =0.001*). Conclusions: Smoking raises STEMI risk, and smokers are more likely than non-smokers to develop coronary artery disease at an earlier age.

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“…Younger patients denied any history of chest pain prior to MI [15]. Older patient frequently have triple vessel disease [10,[16][17][18][19][20]. The long-term prognosis of the patient depends upon the number of vessels involved and the degree of LV dysfunction [11,21,22].…”

Section: Discussionmentioning

confidence: 99%

Is 20s too young to have triple coronary vessel disease?

Umair¹,

Alkhawam²,

Zaiem³

et al. 2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Computed tomography angiography (CTA) was also done which was negative for any acute pulmonary embolism, and anticoagulation was discontinued in the light of negative CTA. The patient was discharged from hospital with follow-up in outpatient department. However, the patient came back to emergency department with worsening dyspnea. Lab work was significant for elevated troponin I and ECG on admission showed normal sinus rhythm and S1Q3T3 pattern. Patient had coronary angiography which showed three vessel disease. IJCRI publishes Conclusion:Smoking is conventionally recognized as the most common risk factor for heart disease. The CAD in young adults has a poor long-term prognosis. Smoking cessation remains a significant challenge in younger population. More awareness and cessation measures are required to address this emerging situation. Given lack of warning signs in these patients, physicians need to be more aggressive in managing risk factors as CAD in younger patient can have adverse outcomes.

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Coronary Arteriographic Findings in Younger Survivors of Acute Myocardial Infarction Including Those with Normal Coronary Arteries

Cited by 15 publications

References 12 publications

Myocardial Infarction at a Young Age (Under 40 Years)

Myocardial Infarction at a Young Age (Under 40 Years)

Effect of Cigarette Smoking on Location of Infarction in Patients Presented with ST-Segment Elevation Myocardial Infarction

Is 20s too young to have triple coronary vessel disease?

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