Predictive Factors after Percutaneous Coronary Intervention in Young Patients with Acute Myocardial Infarction

Abstract

Background and Objectives：Acute myocardial infarction (AMI) at a young age less than 40 years is an uncommon condition and it is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of restenosis in AMI patients who underwent percutaneous coronary intervention (PCI), and these patients were under the age of 40 years. Subjects and Methods：Between January 1997 and December 2006, 88 out of the 121 young AMI patients (mean age: 35.6±4.0 years, 115 males) who underwent follow-up coronary angiography after PCI were divided into two groups: the patients without restenosis (group I: n=62, mean age: 35.6±3.9 years, 60 males) and the patients with restenosis (group II: n=26, mean age: 36.3±3.8 years, 23 males). The clinical and coronary angiographic characteristics were compared between the two groups. Results：Smoking (79.3%) was the most common risk factor in all the patients. The baseline clinical characteristics and baseline laboratory findings were not different between the two groups. There was no significant difference in the sex ratio (p=0.124). The Thrombolysis In Myocardial Infarction (TIMI) flows were not different between the two groups. The level of homocysteine (hcy) was significantly decreased from 12.4±8.8 μmol/L to 9.3±3. 8 μmol/L in group I (p=0.011), but this was not changed significantly in group II (p=0.062). According to multiple logistic regression analysis, a high triglyceride level (>200 mg/dL) was an independent predictor of restenosis (p=0.046). Conclusion：A high level of serum triglyceride is a predictive factor of restenosis after PCI in young age patients with acute myocardial infarction.

The Impact of Smoking on Post-Clopidogrel Platelet Reactivity in Patients With Acute Myocardial Infarction

“…Most epidemiologic studies have strongly supported the conclusion that smoking increases the incidence of fatal coronary artery diseases (CAD), especially AMI. 16 - 20) The magnitude of the risk has been linearly related to the number of cigarettes smoked, with even low levels of smoking being associated with a considerable risk of AMI. Increased risk of CAD due to smoking is associated not only with vasomotor dysfunction but also with inflammatory reactions.…”