Myocardial Infarction In Young Patients Research Articles

Telomere length in young patients with acute myocardial infarction without conventional risk factors: A pilot study from a South Asian population

BackgroundThere is need to identify novel markers that lead to an early occurrence of myocardial infarction (MI) in young South Asian population. This population has different risk profile as compared with others. Telomere length is known to be a marker of aging, and shorter telomeres have been reported in cardiovascular diseases (CVDs). We aimed to identify the association of telomere length in young nonsmokers and non-diabetic MI patients. MethodsIn a case–control study of 154 subjects (n = 77 cases (ages 18–45 years, non-diabetic, non-smoker patients with MI) and n = 77, age and sex matched healthy controls), DNA extraction from peripheral blood leukocytes was carried out and the relative telomere length was estimated by quantitative PCR. The results were adjusted with various demographic parameters like age, gender and body mass index (BMI). The correlation studies were carried out between telomere length, sex and type of MI. ResultsThe relative telomere length was significantly shorter in young MI patients (31–45 years) compared with matched healthy controls (p < 0.0001). Interestingly, in a gender-based comparison, the female patients had shorter telomere length (p < 0.01). ConclusionIn this pilot study, we found that the telomere length was shorter among young, non-diabetic, non-smoker MI patients as compared with similar young controls without MI in a South Asian cohort. Thus, telomere length may be a potential screening tool for young patients who don't have conventional risk factors. Larger studies are needed to confirm these findings.

Evaluation of serum homocysteine in young patients presenting with myocardial infarction: a study from rural Maharashtra

Background: It has been shown that elevated serum homocysteine levels are associated with an increased risk of ischemic heart disease (IHD) and stroke. Also, higher homocysteine concentrations in IHD or stroke patients than in controls have been reported. Some prospective and case-control studies with inconsistent results, some with highly significant results and others with no association have been observed. Objective of the study was to evaluate the serum homocysteine level in young myocardial infarction patients of rural hospital.Methods: The present hospital based cross sectional observational study was carried out in Department of Medicine, MIMER Medical College and Hospital, Talegaon Dabhade, Pune. The study population included 45 young patients having acute myocardial Infarction coming to our hospital. The data thus collected was entered in MS excel sheet and analysed by using SPSS 24.0 IBM USA.Results: Mean age of the study cohort was 36.7 years with 48.9% cases in between the age of 31-40 years and 33.3% were in the age range of 41-45 years. Male predominance was seen in the study cases with 68.9% males and 31.1% females. Prevalence of hyperhmocysteinemia was observed as 64.4% in present study. Mortality rate in our study was 6.67%. Serum homocysteine and all lipid parameters were in positive correlation except High-density lipoprotein which has negative correlation. Homocysteine levels were correlating significantly with level of atherosclerosis as measured by Gensini score.Conclusions: Coronary heart disease is related to high serum homocysteine concentration. Serum homocysteine levels also correlates well with the severity of MI.

CLINICAL STUDY OF ACUTE MYOCARDIAL INFARCTION IN YOUNG ADULTS WITH REFERENCE TO SERUM LIPOPROTEIN, SERUM HOMOCYSTEINE AND HS-CRP

• Introduction - Recently, the prevalence of acute myocardial infarction (AMI) has been increasing in the younger generation. With the advances in the field of medicine, elevated serum levels of various biomarkers like c-reactive protein (CRP), various lipoproteins and homocysteine have been identified to be related to AMI. • Objective - To clinically diagnose acute myocardial infarction in young patients and correlate the levels of serum lipoprotein, serum homocysteine and serum hs-crp and to calculate the level of risk depending on their levels. • Method - A hospital based observational study in which 50 subjects were enrolled in the study as per the inclusion and exclusion criteria. • Results - The results support the current global findings of the younger generation, especially the males, being affected by AMI (Acute Myocardial Infarction). Sedentary lifestyle and BMI &gt;25 can be considered as major risk factors leading to AMI. A considerable proportion of our AMI patients had significantly elevated levels of homocysteine, hs-CRP and lipoprotein A and low levels of HDL-C indicating their correlation with AMI.

Recent trends in acute myocardial infarction among the young.

In recent decades, the incidence of myocardial infarction (MI) has declined among the general population. However, MI rates in the young have not decreased as much as has been observed among older individuals. This review will focus on recent trends of MI in young patients, factors that may account for these trends, and implications for future prevention. MI rates in young patients, particularly in women, have not decreased in the same fashion as they have for their older counterparts, with some studies reporting an increase. The reasons for these findings include underestimation of cardiovascular risk, and accordingly treatment, in the young, as well as an increasing prevalence of risk factors such as obesity and diabetes. Better recognition and treatment of cardiovascular risk factors among young adults may improve outcomes. There is a need for improved methods to assess and treat cardiovascular risk in young individuals.

Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction

BackgroundLeft ventricular ejection fraction (EF) recovery is associated with better long-term outcomes after myocardial infarction (MI). However, the association between long-term outcomes and EF recovery among young MI patients has not been investigated. ObjectivesThis study sought to evaluate the prevalence of left ventricular systolic dysfunction among patients who experience their first MI at a young age and to compare outcomes between those who recovered their EF versus those who did not. MethodsThe YOUNG-MI registry is a retrospective cohort study of patients who experienced an MI at ≤50 years of age. EF at the time of MI and within 180 days post-MI were determined from all available medical records. The primary outcomes were all-cause and cardiovascular mortality. ResultsThere were 1,724 patients with baseline EF data: 503 (29%) had EF <50%, whereas 1,221 (71%) had a normal baseline EF. Patients with lower EF were more likely to have experienced ST-segment elevation MI, have higher troponin values, and have more severe angiographic coronary artery disease. Among patients with abnormal baseline EF, information on follow-up EF was available for 216, of whom 90 (42%) recovered their EF to ≥50%. Patients who experienced EF recovery had less severe angiographic disease, lower alcohol use, and a lower burden of comorbidities. Over a median follow-up of 11.1 years, EF recovery was associated with an ∼8-fold reduction in all-cause mortality (adjusted hazard ratio: 0.12; p = 0.001) and a ∼10-fold reduction in cardiovascular mortality (adjusted hazard ratio: 0.10; p = 0.025). ConclusionsNearly one-third of young patients presented with left ventricular dysfunction post-MI. Among them, EF recovery occurred in more than 40% and was independently associated with a substantial decrease in all-cause and cardiovascular mortality.

Difference in the in-hospital prognosis between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction with high Killip class: Data from the Japan Acute Myocardial Infarction Registry.

ST-segment elevation myocardial infarction is known to be associated with worse short-term outcome than non-ST-segment elevation myocardial infarction. However, whether or not this trend holds true in patients with a high Killip class has been unclear. We analyzed 3704 acute myocardial infarction patients with Killip II-IV class from the Japan Acute Myocardial Infarction Registry and compared the short-term outcomes between ST-segment elevation myocardial infarction (n = 2943) and non-ST-segment elevation myocardial infarction (n = 761). In addition, we also performed the same analysis in different age subgroups: <80 years and ≥80 years. In the overall population, there were no significant difference in the in-hospital mortality (20.0% vs 17.1%, p = 0.065) between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. Patients <80 years of age also showed no difference in the in-hospital mortality (15.7% vs 15.2%, p = 0.807) between ST-segment elevation myocardial infarction (n = 2001) and non-ST-segment elevation myocardial infarction (n = 453) groups, whereas among those ≥80 years of age, ST-segment elevation myocardial infarction (n = 942) was associated with significantly higher in-hospital mortality (29.3% vs 19.8%, p = 0.001) and in-hospital cardiac mortality (23.3% vs 15.0%, p = 0.002) than non-ST-segment elevation myocardial infarction (n = 308). After adjusting for covariates, ST-segment elevation myocardial infarction was a significant predictor for in-hospital mortality (odds ratio 2.117; 95% confidence interval, 1.204-3.722; p = 0.009) in patients ≥80 years of age. Among cases of acute myocardial infarction with a high Killip class, there was no marked difference in the short-term outcomes between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in younger patients, while ST-segment elevation myocardial infarction showed worse short-term outcomes in elderly patients than non-ST-segment elevation myocardial infarction. Future study identifying the prognostic factors for the specific anticipation intensive cares is needed in this high-risk group.

Effects of coronary computer tomography angiography screening on smoking habits in asymptomatic individuals with family history of premature coronary heart disease

Background: The Screening for Asymptomatic Coronary Heart disease in the Siblings of young Myocardial Infarction patients study (SACHSMI) investigated the association between index myocardial infarction patient sibling(s) and obstructive coronary heart disease as detected by coronary computer tomography angiography (CCTA). The results of SACHSMI described a statistically significant association between smoking and prevalence of stenosis detected by CCTA. Data is lacking, however, regarding CCTA screening effects on smoking habits of young individuals. Methods: Fifty asymptomatic siblings of prospectively identified index myocardial infarction patients, aged 55 years or younger, were screened. These 50 sibling participants were shown and explained their CCTA results. The participants were followed using telephone call at 1 and 12 months after screening to assess any change in their smoking habits. The primary outcome of interest was to identify any change in smoking habit among the participants of the SACHSMI study undergoing CCTA 1 and 12 months post scanning. Results: Of the 50 participants, 20 (40%) had a history of smoking. One month post CCTA, 12 (60%; 95% confidence interval (CI): 36% to 81%) participants either stopped smoking (7/20 (35%; 95% CI: 15% to 59%)) or reduced (5/20 (25%; 95% CI: 9% to 49%)) the number of cigarettes smoked daily. At 12 months post CCTA, 11 (55%; 95% CI: 32% to 77%) participants either stopped smoking (6/20 (30%; 95% CI: 12% to 54%)) or reduced (5/20 (25%; 95% CI: 9% to 49%)) the number of cigarettes smoked daily. Conclusions: Screening individuals with family history of premature CHD via CCTA may have the additional benefit of reducing smoking in the short term.

Predicting preventive strategies of acute myocardial infarction in young patients in Egypt: An observational analytical study in the form of cross-sectional study

Background: In the developing countries, coronary artery disease commonly occurred in younger people and is the main cause of mortality worldwide. Aim: This study aims to identify risk factors and characteristics of acute myocardial infarction (AMI) in young patients. To clarify the risk factors for AMI in young patients and the prevention for it, is very important problem worldwide. Patients and Methods: 650 ST-elevation myocardial infarction (STEMI) patients were included in our study. History taking, clinical examination, electrocardiography, echocardiography, and cardiac enzymes and coronary angiography were done to all patients; demographic data and risk factors including mental stress measured by the Standard Stress Scale, left ventricular (LV) dimensions, LV systolic and diastolic function, and angiographic characteristics were measured. We excluded patients with familial dyslipidemia and Type I diabetes. We classified the patients into two groups according to age: Group I – young – 142 patients 45 years. Statistical Analysis: Variables were expressed as the mean ± standard deviation. Percentage was used for categorical variables. t-test was used for comparison. Then, the significant univariate predictors were assessed by multivariate linear regression analysis to find the independent predictors for unfavorable outcome. Data analyses were performed with SPSS (version 21.0, Chicago Inc., Chicago, Illinois, USA). Results: Young patients were 142 (21.8%); males were majority between both groups. Smoking (56.3%), addiction (17.6%), mental stress (79.6%), and family history (4.2%) were significantly associated with young age group. Spontaneous coronary dissection (SCAD) (6.3%) and coronary spasm (10.5%) are relatively common cause of young AMI patients. SCAD and spasm has its specific risk factors such as young female and smoking, respectively. Anterior STEMI occurred in 59.1% of young patients and was the most common followed by Inferior STEMI in 31%. 14.8% of young patients presented late after 12 h of onset of symptoms. The multivariate logistic regression for independent predictors of unfavorable outcome showed that hypertension, Type II diabetes mellitus, Killip class, and multiple-vessel disease were significant predictors of unfavorable outcome. Conclusion: The prevalence of STEMI in young patients is increasing due to sedentary and stressful lifestyle and bad habits as smoking and addiction. Young patients have unique risk factor profile. STEMI in young occurred most often in males. Smoking is the most common risk factor. Anterior STEMI is the most common followed by inferior STEMI.

To determine the prevalence of dyslipidemia and lipoprotein abnormalities among siblings of young acute myocardial infarction patients.

Introduction: Despite all available theoretical assumptions, there is no study defining the prevalence of lipid and lipoprotein abnormalities among siblings of young acute myocardial infarction (MI) patients. This is the first such study. Methods: This was a case-control study. A total 110 siblings of young acute MI patients (Group A) and 50 healthy young controls (Group B) were studied for a duration of 2 years. Clinical profiles included age, sex, smoking, hypertension, diabetes mellitus, abdominal obesity and dyslipidemia for both cases and controls.The primary objective was to study the prevalence of dyslipidemia and lipoprotein abnormalities. The secondary objective was to study the prevalence of conventional risk factors among siblings of young (<45 years) acute MI patients. Results: On analyzing lipid profiles, it was found that total cholesterol, triglycerides, low-density lipoprotein, ApoB100, ApoB100: ApoA-1 ratio, and lipoprotein (a) were significantly raised in Group A in comparison to Group B. On studying conventional risk factors, it was observed that history of smoking, hypertension, diabetes mellitus, and increased waist circumference were more prevalent in Group A in comparison to Group B. Conclusion: Conventional atherosclerotic risk factors, lipid and lipoprotein abnormalities were significantly more prevalent in siblings of young acute MI patients in comparison to healthy controls and may be an answer to the possible cause of familial clustering in young MI emphasizing the importance of familial screening. Therefore, intensive efforts should be made to identify and alter modifiable risk factors in these cases.

Association of Serum Vitamin D with Acute Myocardial Infarction in Young Patients (≤40 Years)

Background: Coronary heart disease (CHD) is the leading cause of death worldwide, with acute myocardial infarction (AMI) being the most severe manifestation. Recent evidence suggests that vitamin D deficiency (moderate/severe) is an important risk factor for coronary artery disease.&#x0D; Objectives: Considering paucity of the literature focusing young MI, the study was planned to assess the relation of different grades of low serum vitamin D with AMI in young patients admitted in a tertiary care hospital.&#x0D; Methods: This Hospital based case-control study was conducted in the department of cardiology in Dhaka Medical College Hospital (DMCH) over 1-year period. Patients with acute MI in young age (≤40 years) admitted in the CCU of DMCH were approached for inclusion in the study. Total 120 subjects (60 cases and 60 controls) were studied. Patients with acute MI were considered as cases and similar number of age and sex matched apparently healthy individual were included as controls. All study population were subjected to relevant investigations and detailed history along with socio-demographic data were collected. Serum vitamin D levels were categorized as severe vitamin D deficiency as a level &lt;10ng/ml, moderate vitamin D deficiency at a level 10-20 ng/ml, vitamin D insufficiency as 21-29 ng/ml and a level of ≥30ng/ml was considered as normal. Serum 25(OH) vitamin D assay was performed for cases and controls using chemiluminescence immunoassay. Vitamin D status (normal/insufficiency vs moderate/severe deficiency) was studied among cases and controls. All necessary information were recorded in a pretested case record form. Statistical analyses were done by SPSS 22.&#x0D; Results: Mean age of cases and controls were 35.31±4.84 and 33.83±5.11 years respectively. Vitamin D deficiency (moderate/severe) was present in 86.7% cases and 46.7% controls and the difference was statistically significant (P&lt;0.001). Among 60 cases of acute MI, 83% patients had acute ST segment elevated myocardial infarction and 17% patients had acute non-ST segment elevated myocardial infarction. Vitamin D deficient (moderate/severe) subjects were more likely to develop AMI than subjects who had normal/insufficient vitamin D levels in blood (OR 7.42, 95%CI 3.18-18.28, P&lt;0.001). And among all the usual coronary risk factors, vitamin D deficiency (moderate/ severe), Hypertension, Family history of premature CAD and smoking were significantly associated with increased incidence of acute MI (STEMI and NSTEMI) (P value&lt;0.05 in all cases).&#x0D; Conclusion: Vitamin D deficiency (moderate/severe) is associated with increased incidence of acute MI in young age (≤40 years).&#x0D; Bangladesh Heart Journal 2019; 34(2) : 80-85

Comparison of Fasting Lipid Profile and Prior Lipid-Lowering Agent among Young and Older Myocardial Infarction Patients

Comparison of Fasting Lipid Profile and Prior Lipid-Lowering Agent among Young and Older Myocardial Infarction Patients

Risk Factors and Outcomes of Very Young Adults Who Experience Myocardial Infarction: The Partners YOUNG-MI Registry

BackgroundDespite significant progress in primary prevention, the rate of myocardial infarction has not decreased in young adults. We sought to compare the risk factor profiles and outcomes between individuals who experienced a first myocardial infarction at a very young (≤40 years) and a young (age 41-50 years) age. MethodsWe evaluated all patients ≤50 years of age admitted with a Type 1 myocardial infarction to 2 large academic hospitals from 2000 to 2016. Risk factors were determined by review of electronic medical records. The primary outcomes of interest were all-cause and cardiovascular mortality. ResultsAmong 2097 consecutive young patients with myocardial infarction, 431 (20.5%) were ≤40 years of age. When compared with their older counterparts, very young patients had similar risk profiles, with the exception of greater substance abuse (17.9% vs 9.3%, P < .001) and less hypertension (37.9% vs 50.9%, P < .001). Spontaneous coronary artery dissection was more prevalent in very young patients (3.1% vs 1.1%, P = .003). Over a median follow-up of 11.2 years, very young myocardial infarction patients had a similar risk of all-cause and cardiovascular mortality. ConclusionsDespite being, on average, 10 years younger and having a lower prevalence of hypertension, very young myocardial infarction patients had similar 1-year and long-term outcomes when compared with those aged 41 to 50 years at the time of their index infarction. Our findings suggest the need for aggressive secondary prevention measures in very young patients who experience a myocardial infarction.

Correlation of serum cholestryl ester transfer protein (CETP) level with lipid profile in young myocardial infarction patients

Correlation of serum cholestryl ester transfer protein (CETP) level with lipid profile in young myocardial infarction patients - IJCBR- Print ISSN No: - 2394-6369 Online ISSN No:- 2394-6377 Article DOI No:- 10.18231/j.ijcbr.2019.079, International Journal of Clinical Biochemistry and Research-Int J Clin Biochem Res

Характеристика коронарного судинного русла, структурно-функціонального стану серця та ендотелійзалежної вазодилатації у хворих молодого віку з гострим коронарним синдромом з елевацією сегмента ST

The aim – to reveal features of the coronary vascular system, structural and functional state of the heart and endothelium-dependent vasodilatation in ST-elevation acute coronary syndrome (STEMI) patients of different age groups.Materials and methods. We analyzed the data of instrumental examination of patients who were admitted to the emergency departments from 2000 to 2015, with STEMI. Patients were distributed into two groups depending on age: 1 group – patients &lt; 45 years, 2 group  45 years. Coronary angiography (CAG) was performed within the first hours after the admission. Endothelium-dependent, flow-mediated vasodilation (FMD) test and echocardiography were performed within 24 hours of admission and again on the 7th day.Results and discussion. According to сoronary angiography, elder patients were more likely to have infarction-dependent coronary artery disease (33.3 vs. 20.3 %; p=0.037), and multi-vessel coronary artery disease (12.0 vs. 4.8 %; p=0.048). Patients in the 1st group demonstrated a lower frequency of hemodynamically significant lesions of coronary vessels (p&lt;0.001) and less marked disorders of the lipid spectrum. Patients of the group 1 had less thickness of the interventricular septum. 10.7±1.5 mm versus 11.6±1.6 mm, p=0.024). Young patients had initially better diastolic function (Е/А) (1.29±0.40 versus 1.00±0.52, p=0.008). At day 7 in patients of the 1st group there was a more marked increase in the left ventricularejection fraction and end-diastolic diastolic index of the left ventricle (7.6 versus 3.4 %; p&lt;0.05) than in the patients of the 2nd group. Young patients demonstrated a tendency to increase of end-diastolic index &gt; 10 %, in dynamics, at 39.7 versus 27.8 % elder patients (p=0.053), lower growth of the diameter of the brachial artery (4.7±4.1 vs. 6.7±5.1 %; p&lt;0.05), but more rapid improvement of endothelial function in the dynamics of observation (104 vs. 23 %; p&lt;0.05).Conclusions. The percentage of damage of coronary artery disease in STEMI young patients did not differ from elder patients but insignificant coronary artery stenosis is detected more often (р&lt;0.001) and acute myocardial infarction in the right coronary artery is less common (р&lt;0.037). Young patients with multi-vessel coronary disease have significant violations of the lipid blood spectrum (increased levels of total cholesterol, low density lipoprotein cholesterol). Indicators of intracardiac hemodynamic did not differ between age groups initially, however, the course of acute myocardial infarction in young patient was characterized by the tendency to develop early post-infarction dilatation (p=0.053). According to the FMD test young patients at the onset had a worse indicator of than elder patients (p&lt;0.043), however the diameter of the brachial artery in the dynamics of observation, significantly increased (p&lt;0.05).

High-Risk Carotid Imaging Predicts ST-Segment Elevated Myocardial Infarction in Young Patients: A Cross-Sectional Study

High-Risk Carotid Imaging Predicts ST-Segment Elevated Myocardial Infarction in Young Patients: A Cross-Sectional Study

Increased coagulation factor XIII activity but not genetic variants of coagulation factors is associated with myocardial infarction in young patients

The aim of the study was to investigate the possible role of coagulation factor XIII (FXIII) plasma activity and its gene (F13A1) Val34Leu variant as well as thrombospondin-2 gene (THBS2) T/G 3′UTR and thrombospondin-4 gene (THBS4) Ala387Pro variants in the development of myocardial infarction (MI) in young patients. The studied group consisted of 158 patients aged < 50 years with MI, and the control groups consisted of 150 healthy people aged < 50 years and 202 patients suffering from MI aged ≥ 50 years. Factor XIII activity was measured by photometric assay; genetic variants were determined using the restriction fragment length polymorphism (RFLP) method. FXIII activity was significantly higher in the young MI group compared with young healthy controls and the MI ≥ 50 group (126.2 U/dl vs. 109.6 U/dl, p < 0.0001; 126.2 U/dl vs. 119.8 U/dl, p = 0.01, respectively). FXIII activity did not correlate with F13A1 gene variants. F13A1, THBS2 and THBS4 genotypes were equally distributed in all studied groups. There was also no statistically significant differences in the prevalence of the extended CC/TT/GG haplotype of F13A1/THBS2/THBS4 variants between the young MI group and the young healthy control group and between the young MI group and the MI aged ≥ 50 group. In conclusion, our study revealed that increased FXIII activity is associated with an increased risk of MI in young patients. None of studied single genetic variants—F13A1 Val34Leu, THBS2 T/G 3′UTR and THBS4 Ala387Pro—and the extended CC/TT/GG haplotype of F13A1/THBS2/THBS4 genes was associated with MI in young age.

A Comparative Study on Acute Myocardial Infarction in Young Patients (&lt; 45 Years) in Comparison of Old Age Patients (45 Yrs or More)

A Comparative Study on Acute Myocardial Infarction in Young Patients (&lt; 45 Years) in Comparison of Old Age Patients (45 Yrs or More)

Particularities of Acute Myocardial Infarction in Young Adults

Abstract Coronary heart disease occurs more often in patients over the age of 45. However, recent data shows a growing incidence of coronary events in younger patients also. Young patients with acute myocardial infarction (AMI) represent a relatively small proportion of subjects suffering from an acute ischemic event. However, they represent a subset that is distinguished from elderly patients by a different profile of risk factors, often atypical clinical presentation, and different prognosis. The prevalence of risk factors such as smoking, dyslipidemia, and a family history of coronary events is higher in this group of patients compared to the general population with AMI. Because of an important negative impact on the patients’ psychology, impaired working abilities, and a high socioeconomical burden, myocardial infarction in young patients represents an important cardiovascular pathology. This manuscript aims to present the particularities of AMI occuring at a young age, in comparison with the rest of the population with AMI.

Adherence to guidelines for pharmacological treatment of young adults with myocardial infarction in Poland: Data from Polish Registry of Acute Coronary Syndromes (PL-ACS).

Myocardial infarction (MI) in young adults accounts for up to 10% of all cases. Regarding life expectancy and professional activity, it is extremely important to restore and maintain young patients' full performance. Therefore, secondary prevention is especially vital in this group of patients. The paper focuses on the analysis of pharmacotherapy in young MI patients in Poland, assessing disparities between the European Society of Cardiology guidelines and clinical practice, and regional differences among the provinces. The analysis was conducted using the data from a nationwide, observational, multicentre, prospective study-the Polish Registry of Acute Coronary Syndromes (PL-ACS). The data were collected from patients ≤45years old with MI who were hospitalized in the period 2010-2014. A retrospective study included 6367 MI patients. They constituted 3.9% of all the patients with MI in Poland. Despite the fact that during hospitalization regional differences were observed in case of acetylsalicylic acid (range 70.3%-93.8%), β-blockers (range 50.0%-79.6%), statins (range 53.4%-85.7%) and angiotensin-converting enzyme inhibitors (range 46.9%-75.0%), the majority of patients received the drugs according to the guidelines. Regional differences found at discharge also regarded those medications, but the range of observed variations was smaller. On average, three-quarter of patients received guideline-recommended medications. Still, in some provinces, almost a quarter of patients were administered those medications only at discharge. In the study population, there were significant differences between the provinces regarding pharmacotherapy during hospitalization, which concerned major groups of medications. However, pharmacotherapy indicated at discharge revealed fewer regional differences and adhered to guideline recommendations to a greater extent. Nevertheless, there is still some room for improvement, especially with regard to pharmacotherapy during hospitalization.

High-Risk Carotid Imaging Predicts ST-Segment Elevated Myocardial Infarction in Young Patients: A Cross-Sectional Study

High-Risk Carotid Imaging Predicts ST-Segment Elevated Myocardial Infarction in Young Patients: A Cross-Sectional Study