Demographic data and predictors of acute myocardial infarction in Egyptian young adults

Abstract

Abstract Background Myocardial Infarction carries a significant morbidity, psychological effects, and financial constraints for the patient and the family when it occurs at young age. However there is limited data on the clinical features of young adults with AMI in Egypt and the Middle Eastern region. We therefore sought to investigate the clinical profile, risk factors and angiographic variables of this age group in Egypt. Aim of the Work To determine the clinical profile and prevalence of different risk factors including Cigarette Smoking, Tramadol use, Cannabis smoking, HDL & LDL levels, stressful lifestyle and bad sleeping habits in Egyptian patients presented with Myocardial Infarction for the first time at age ≤45 years. Methods We conducted a cross sectional observational study on 106 consecutive patients aged ≤45 years admitted with 1st time myocardial infarction in the period between February 2018 and August 2018 at Ain Shams University, Egypt. Clinical, and Angiographic variables were recorded from all patients. Results Out of 1207 patients admitted with 1st time MI, 106 were young that gave a prevalence of 8.8% in our center. Out of 106 patients, 101 were male. Mean age was 39.19 yrs. 71 patients had ST elevation myocardial infarction (MI) (67%) and 35 had non ST elevation MI (33%). Anterior wall MI was present in 49 patients (46.2%), inferior wall MI in 20 patients (18.9%) and lateral wall MI in 2 patients (1.9%). 93 patients (88%) were smokers, 31 patients (29.2%) were Tramadol users, 43 patients(40.6%) smoked cannabis, 50 patients (47.2%) had bad sleeping habits, 29 patients (27.4%) had high stress levels, 37 patients (34.9%) were hypertensive, 22 patients were diabetic (20.8%). Family history of CAD was present in 20 (18.9%) patients. Low High-density lipoprotein (HDL) was seen in 47 patients (44.3%), and high Low-density lipoprotein in 20 patients (18.9%). LAD was involved in 56% of patients, with a significant association between Tramadol use and LAD involvement. We found significant association between both Tramadol use and Cannabis smoking and the presence of Heavy thrombus burden in Coronary Angiography. Conclusion AMI in the young almost exclusively occurs in male, Anterior wall MI is most common, with LAD being involved in around half of patients. Smoking, hypertension, low HDL, Tramadol use, Cannabis smoking, and bad sleeping habits are the major risk factors. Tramadol use was associated with significant affection of LAD. Tramadol use and Cannabis smoking were associated with high thrombus burden on coronary angiography,