Acute Ischemic Heart DiseaseAcute myocardial infarction in young adults: Prognostic role of angiotensin-converting enzyme, angiotensin II type I receptor, apolipoprotein E, endothelial constitutive nitric oxide synthase, and glycoprotein IIIa genetic polymorphisms at medium-term follow-up☆
Section snippets
Study population
The study population was recruited from patients ≤45 years of age, consecutively admitted between 1992 and 1995 to the coronary care units of 3 different hospitals (S. Giovanni Battista and Maria Vittoria, Turin, SS. Annunziata, Savigliano), who satisfied the World Health Organization criteria for the diagnosis of myocardial infarction.17
Risk factor data were obtained from each patient and included age, sex, body mass index, smoking habits, history of hypercholesterolemia (total cholesterol
Results
The study population consisted of 106 young patients (mean age 40 ± 4 years, range 23 to 45) with AMI. The fraction of female patients was low (5%), in agreement with the prevalence of coronary disease in young women. Smoking (72%), hypercholesterolemia (52%), and family history of CAD (35%) were the more prevalent risk factors. History of CAD was rare (6%). More than half (52%) of the patients had anterior AMI. Coronary angiography was performed in 94 patients. Significant lesion (stenosis
Discussion
Epidemiologic and clinical data from the studies performed on young adults with premature AMI have shown that the occurrence of myocardial infarction in young Italian people is uncommon (2% in GISSI study), prognosis in short-term outcome is good (mortality rate <2% in GISSI study), and conventional risk factors are usually present despite the observation that the cardiovascular risk profile is peculiar when compared with older patients.6, 7 Young patients, in fact, have significantly higher
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Reprint requests: Serena Bergerone, MD, Cardiologia Universitaria, Dipartimento di Medicina Interna, Ospedale Molinette, C.so Dogliotti 14 – 10126, Torino, Italia.