Abstract
Aim. To study the clinical features and risk factors (RF) associated with the development of acute coronary syndrome (ACS) in young patients.Material and methods. The study included 474 patients with ACS. Depending on age, patients were divided into 2 groups. The first group consisted of 299 patients of young age (25-44 years), the comparison group consisted of 175 patients of mean and old age (45-74 years). Clinical and anamnestic data, parameters of general clinical and biochemical tests, electrocardiography, echocardiography and coronary angiography were determined in all patients, and polymorphisms in FII G20210-A, FV G1691-A, MTHFR C677-T genes were determined in 116 patients. The control group consisted of 53 healthy volunteers.Results. ACS in patients <45 years old is most common in men. The number of women with ACS increases as elder patient is. The incidence of myocardial infarction (MI) and unstable angina, ST-elevated MI and non ST-segment elevation MI, Q-wave and non-Q-wave MI had no differences between patients of the younger and older age groups. In younger patients, anterior localization of myocardial infarction was more common, in mean and old patients — posterior. Complications of MI in young patients were less common than in the comparison group. In patients of mean and old ages, acute coronary event was preceded by a clinic of angina, in young patients most often it was the debut of coronary artery disease. It was revealed that single-vessel coronary lesion is more characteristic for young patients, for the elderly patients — two-vessel and multi-vessel. Pathology of the anterior descending coronary artery prevailed in both groups of patients. Most patients in both groups underwent myocardial revascularization. MI as a result of coronary artery thrombosis happened more often in young patients. The most significant RF associated with the ACS development were: increased total cholesterol and low density lipoproteins, decreased high density lipoproteins, increased body mass index, smoking, polymorphism of MTHFR-homozygote, hereditary tainted with smoking, aggravation in combination with F5-homozygote, hereditary tainted in combination with MTHFR-homozygote, hereditary tainted in combination with smoking and MTHFR homozygote.Conclusion. We identified clinical features and RF, mostly associated with the development of ACS in patients <45 years of age. The results can serve as additional indicators showed the risk of ACS development.
Highlights
The most significant risk factors (RF) associated with the acute coronary syndrome (ACS) development were: increased total cholesterol and low density lipoproteins, decreased high density lipoproteins, increased body mass index, smoking, polymorphism of MTHFR-homozygote, hereditary tainted with smoking, aggravation in combination with F5-homozygote, hereditary tainted in combination with MTHFR-homozygote, hereditary tainted in combination with smoking and MTHFR homozygote
We identified clinical features and RF, mostly associated with the development of ACS in patients
The results can serve as additional indicators showed the risk of ACS development
Summary
Острый коронарный синдром у пациентов молодого возраста: клинические особенности и факторы риска. Изучить клинические особенности и факторы риска (ФР), ассоциированные с развитием острого коронарного синдрома (ОКС) у пациентов молодого возраста. Первую группу составили 299 пациентов молодого возраста (25-44 года), группу сравнения 175 пациентов среднего и пожилого возрастов (45-74 года). В результате выполненного логистического регрессионного aнaлизa у пациентов молодого возраста была определена совокупность наиболее значимых ФР, ассоциированных с развитием ОКС: повышeниe уровня общего холестерина, липопротеинов низкой плотности, снижeниe уровня липопротеинов высокой плотнос ти, увеличение индекса массы тела, фaкт курeния, нaличиe полиморфизмa MTHFR-гомозиготы, отягощeннaя нaслeдствeнность в сочeтaнии с курeниeм, с F5-гомозиготой, с MTHFR-гомозиготой, в комбинaции с курeниeм и MTHFR-гомозиготой. В результате исследования были выделены клинические особенности и ФР, в большей степени, ассоциированные с развитием ОКС у пациентов
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.