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MYOCARDIAL INFARCTION IN YOUNG PATIENTS: CAUSES AND PROGNOSIS

https://doi.org/10.17650/1818-8338-2016-10-4-10-15

Abstract

Myocardial infarction (MI) is unusual among young people, but with an upward trend in changing to unhealthy lifestyle, there is growing proportion of patients with MI are aged > 45 years. Premature MI individuals were predominantly males, characterized by smoking, obesity, and dyslipidemia (an essential key contributing to atherosclerosis). Many studies have reported that unemployment has also a negative effect on health. MI in young adults is generally caused by thrombus arising secondary to the rupture of the atherosclerotic plaque in coronary artery. As opposed to lesions associated with plaque rupture, those thatunderlie superficial erosion do not have thin fibrous caps, harbor fewer inflammatory cells, lack large lipid pools. Superficial erosion occurs morecommonly in women and the elderly. Normal coronary arteries in young adults with MI is related to coronary vasospasm, embolus arising from endocardium or heart vessels, platelet aggregation, and other reasons. Heart failure (HF) is a common complication of MI. With timely access to medical care and good adherence to treatment older patients are at greater risk of developing heart failure.

About the Authors

E. V. Konstantinova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Department of Faculty Therapy named after Acad.A. I. Nesterov.

1 Ostrovityanova St., Moscow 117997



N. M. Balayan
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Department of Faculty Therapy named after Acad.A. I. Nesterov.

1 Ostrovityanova St., Moscow 117997



N. A. Shostak
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Department of Faculty Therapy named after Acad.A. I. Nesterov.

1 Ostrovityanova St., Moscow 117997



References

1. Gupta A., Wang Y., Spertus J.A. et al. Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J Am Coll Cardiol 2014;64(4):337–45. DOI: 10.1016/j.jacc.2014.04.054.

2. Doughty M., Mehta R., Bruckman D. et al. Acute myocardial infarction in the young – The University of Michigan experience. Am Heart J 2002;143(1):56–62. PMID: 11773912.

3. Yunyun W., Tong L., Yingwu L. et al. Analysis of risk factors of ST-segment elevation myocardial infarction in young patients. BMC Cardiovasc Disord 2014;14:179. DOI: 10.1186/1471-2261-14-179.

4. Pineda J., Marín F., Marco P. et al. Premature coronary artery disease in young (age < 45) subjects: Interactions of lipid profile, thrombophilic and haemostaticmarcers. Int J Cardiol 2009;136(2):222–5. DOI: 10.1016/j.ijcard.2008.04.020.

5. Schoenenberger A.W., Radovanovic D., Stauffer J.C. et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. Int J Cardiol 2011;148(3):300–4. DOI: 10.1016/j.ijcard.2009.11.009.

6. Diagnosis and treatment of patients with acute myocardial infarction with ST-segment elevation of the electrocardiogram (part 1). Recommendations of the society of specialists in emergency cardiology. Neotlozhnaya kardiologiya = Emergency Cardiology 2014;(1):43–62. (In Russ.).

7. Clinical guidelines for the diagnosis and treatment of patients with acute coronary syndrome without ST-segment elevation of the electrocardiogram (part 1). Recommendations of the society of specialists in emergency cardiology. Neotlozhnaya kardiologiya = Emergency Cardiology 2016;(2):26–62. (In Russ.).

8. Dalager S., Paaske W.P., Kristensen I.B. et al. Artery-related differences in atherosclerosis expression: implications for atherogenesis and dynamics in intima-media thickness. Stroke 2007;38(10):2698–705. DOI: 10.1161/STROKEAHA.107.486480. PMID: 17761918.

9. Chiodini B.D., Barlera S., Franzosi M.G. et al. APO B gene polymorphisms and coronary artery disease: a meta-analysis. Atherosclerosis 2003;167(2):355–66. PMID: 12818419.

10. Kiechl S., Lorenz E., Reindl M. et al. Toll-like receptor 4 polymorphisms and atherogenesis. N Engl J Med 2002;347(3):185–92. DOI: 10.1056/NEJMoa012673. PMID: 12124407.

11. Kaplan R.C., Smith N.L., Zucker S. et al. Matrix metalloproteinase-3 (MMP3) and MMP9 genes and risk of myocardial infarction, ischemic stroke, and hemorrhagic stroke. Atherosclerosis 2008;201(1):130–7. DOI: 10.1016/j.atherosclerosis.2008.01.003.

12. Burke A.P., Kolodgie F.D., Farb A. et al. Morphological predictors of arterial remodeling in coronary atherosclerosis. Circulation 2002;105(3):297–303. PMID: 11804983.

13. Varnava A.M., Mills P.G., Davies M.J. Relationship between coronary artery remodeling and plaque vulnerability. Circulation 2002;105(8):939–43. PMID: 11864922.

14. Stary H.C., Chandler A.B., Dinsmore R.E. et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995;92(5):1355–74. PMID: 7648691.

15. Libby P., Theroux P. Pathophysiology of coronary artery disease. Circulation 2005;111(25):3481–8. DOI: 10.1161/CIRCULATIONAHA. 105.537878. PMID: 15983262.

16. Virmani R., Burke A.P., Farb A., Kolodgie F.D. Pathology of the vulnerable plaque. J Am Coll Cardiol 2006; 47(8 Suppl):C13–8. DOI: 10.1016/j.jacc.2005.10.065. PMID: 16631505.

17. Campbell I.C., Suever J.D., Timmins L.H. et al. Biomechanics and inflammation in atherosclerotic plaque erosion and plaque rupture: implications for cardiovascular events in women. PLoS One 2004;9(11):e111785. DOI: 10.1371/journal.pone.0111785.

18. Naghavi M., Libby P., Falk E. et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation 2003;108(14):1664–72. DOI: 10.1161/01.CIR.0000087480.94275.97. MID: 14530185.

19. Libby P., Pasterkamp G. Requiem for the “vulnerable plaque”. Eur Heart J 2015;36(43):2984–7. DOI: 10.1093/eurheartj/ehv349.

20. Aikawa M., Rabkin E., Okada Y. et al. Lipid lowering by diet reduces matrix metalloproteinase activity and increases collagen content of rabbit atheroma: a potential mechanism of lesion stabilization. Circulation 1998;97(24):2433–44. PMID: 9641696.

21. Guo R.W., Yang L.X., Wang H. et al. Angiotensin II induces matrix metalloproteinase-9 expression via a nuclear factorkappaB-dependent pathway in vascular smooth muscle cells. Regul Pept 2008;147(1–3):37–44. DOI: 10.1016/j.regpep.2007.12.005.

22. Schonbeck U., Libby P. Inflammation, immunity, and HMG-CoA reductase inhibitors: statins as anti-inflammatory agents? Circulation 2004; 109(21 Suppl 1):II18–26. DOI: 10.1161/01.CIR.0000129505.34151.23. PMID: 15173059.

23. Jamil G., Jamil M., Alkhazraji H. et al. Risk factor assessment of young patients with ST-segment elevation myocardial infarction. Am J Cardiovasc Dis 2013;3(3):170–4. PMID: 23991352.

24. Larsen G.K., Seth M., Gurm H.S. The ongoing importance of smoking as a powerful risk factor for ST-segment elevation myocardial infarction in young patients. JAMA Intern Med 2013;173(13):1261–2. DOI: 10.1001/jamainternmed.2013.6075.

25. Eliason M., Storrie D. Job loss is bad for your health – Swedish evidence on causespecific hospitalization following involuntary job loss. Soc Sci Med 2009;68(8):1396–406. DOI: 10.1016/j.socscimed.2009.01.021.

26. Herbig B., Dragano N., Angerer P. Health in the long-term unemployed. Dtsch Arztebl Int 2013;110(23–24):413–9. DOI: 10.3238/arztebl.2013.0413.

27. Davidovich I.M., Malay L.N., Kutishenko N.P. The analysis of long-term outcomes and adherent to treatment in patients after myocardial infarction: Khabarovsk Register Data. Klinitsist = Clinician 2016–2017;(4–1):36–44. (In Russ.).

28. Torabi A., Cleland J.G., Rigby A.S. et al. Development and course of heart failure after a myocardial infarction in younger КЛИНИЦИСТ 4’2016/1’2017 ТОМ 10/11 THE CLINICIAN 4’2016/1’2017 VOL. 10/11 and older people. J Geriatr Cardiol 2014;11(1):1–12. DOI: 10.3969/j.issn.1671-5411.2014.01.002.

29. D’Ascenzo F., Biondi-Zoccai G., Moretti C. et al. TIMI, GRACE and alternative risk scores in acute coronary syndromes: a meta-analysis of 40 derivation studies on 216.552 patients and 42 validation studies on 31.625 patients. Contemp Clin Trials 2012;33(3):507–14. DOI: 10.1016/j.cct.2012.01.001.

30. Baptista S.B., Farto e Abreu P., Loureiro J.R. et al. PAMI risk score for mortality prediction in acute myocardial infarction treated with primary angioplasty. Rev Port Cardiol 2004;23(5):683–93. PMID: 15279453.

31. Halkin A., Singh M., Nikolsky E. et al. Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. J Am Coll Cardiol 2005;45(9):1397–405. DOI: 10.1016/j.jacc.2005.01.041. PMID: 15862409.

32. Schmidt E.A., Berns S.A., Osokina A.V. et al. Scale prediction of adverse outcomes in patients with myocardial infarction with ST-segment elevation undergoing emergency percutaneous coronary intervention. Terapevticheskiy arkhiv = Therapeutic Archive 2014;86(4):13–8. (In Russ.).

33. Belaya I.E., Kolomiets V.I., Musaeva E.K. Significance of laboratory parameters in prognosis of outcomes of acute myocardial infarction. Klinitsist = Clinician 2016–2017;(4–1):29–35. (In Russ.).


Review

For citations:


Konstantinova E.V., Balayan N.M., Shostak N.A. MYOCARDIAL INFARCTION IN YOUNG PATIENTS: CAUSES AND PROGNOSIS. The Clinician. 2017;11(1):10-15. (In Russ.) https://doi.org/10.17650/1818-8338-2016-10-4-10-15

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ISSN 1818-8338 (Print)
ISSN 2412-8775 (Online)