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Acute coronary syndromes in young patients: Presentation, treatment and outcome
International Journal of Cardiology, 05/03/2011
Clinical Article
Schoenenberger AW et al. - Young patients with Acute coronary syndromes (ACS) differed from older patients in that the younger often presented with ST-segment elevation myocardial infarction (STEMI), received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.
Methods- In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008.
- ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).
- 195 patients (0.7%) were 35years old or younger.
- Compared to patients >35years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; P<0.001).
- STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; P<0.001).
- Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%).
- he prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients.
- Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events.
