Risk Factor Differences in Acute Myocardial Infarction between Young and Older People: A Systematic Review and Meta-Analysis

Zeng Bin,Liu Lei

doi:10.5935/2359-4802.20190004

Abstract

Abstract Acute myocardial infarction (AMI) is less frequent in young individuals (≤ 45 years) than in older ones (> 45 years). Young AMI patients differ from older AMI patients in different ways. This article aims to assess the differences between young and older AMI patients. A search was made in the database of Cochrane Library, PubMed, BioMed Central and Embase, sence their establishment to December 2016, using the key words: risk factors, clinical characteristics, acute myocardial infarction and young. Meta-analysis was performed by using the Review Manager 5.3 software, pooled odds ratios and 95% confidence intervals were used to assess the strength of differences. Eight studies with fairly quality, enrolling 13,358 patients in the analysis. Compared with older AMI patients, young AMI patients had a higher rate of smoking and obesity (OR = 2.71,95%CI:1.87 to 3.92; OR = 1.76,95%CI:1.13 to 2.74), higher rate of family history of coronary artery disease and alcohol consumption (OR = 2.36,95%CI:1.22 to 4.59; OR = 1.76,95%CI:1.04 to 2.97). Moreover, Young AMI patients had a lower rate of hypertension and diabetes mellitus (OR = 0.52,95%CI:0.37 to 0.73; OR = 0.58,95%CI:0.50 to 0.67). No significant differences were observed in hyperlipidemia, a subgroup data-analysis showed a higher total cholesterol, triglyceride lipase, and low-density lipoprotein levels (p < 0.05), and lower levels of high-density lipoprotein (p < 0.01) in young AMI patients. Smoking, family history of coronary artery disease, obesity and alcohol consumption are the most main risk factors of AMI among young individuals, and young AMI patients have better prognosis than older ones.

Highlights

Cardiovascular disease (CVD) is a global health problem that has reached epidemic proportions in both developed and developing countries.[1]
We found that young Acute myocardial infarction (AMI) patients had comparatively higher levels of serum TG (p = 0.01), low-density lipoprotein (LDL) (p = 0.001), total cholesterol (TC) (p = 0.002) and lower levels of serum high-density lipoprotein (HDL) (p = 0.008) than older AMI patients
Zimmerman et al.,[21] reported that males show an absolute predominance among young AMI patients; there is a tendency for the incidence of myocardial infarction to be equal in both sexes with increasing age

Summary

Introduction

Cardiovascular disease (CVD) is a global health problem that has reached epidemic proportions in both developed and developing countries.[1] Even though the rates of death caused by CVD have declined, yet the burden of disease remains high. Studies showed that young AMI patients differed from older AMI patients in several ways, including risk factors, clinical characteristics, coronary angiographic characteristics and prognosis.[5] AMI in young individuals can cause death and disability in the prime of life, in addition to being an increasing economic burden for both the patients’ family and the government. Because of the potential of premature death and long-term disability in young AMI patients, clinical interest in young adults is increasing.[6] Identifying the major risk factors for AMI in this group of young individuals is of vital significance to develop effective prevention strategies

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