Original Research Article
Year: 2022 | Month: July-September | Volume: 7 | Issue: 3 | Pages: 211-216
DOI: https://doi.org/10.52403/ijshr.20220730
Analysis of Conventional and Nonconventional Risk Factors, Clinical Profile and Angiographic Correlation in Young Myocardial Infarction at Tertiary Care Centre
J. Nambirajan1, Harshal Pamecha2, D. Chakkravarthi3, J. Jegadeesh4
1Professor and Head, department of cardiology, Coimbatore Medical College Hospital, Coimbatore, India
2Postgraduate, department of cardiology, Coimbatore Medical College Hospital, Coimbatore, India
3,4Assistant Professor, department of cardiology, Coimbatore Medical College Hospital, Coimbatore, India
Corresponding Author: Harshal Pamecha
ABSTRACT
Background: CAD in the young require special attention as the clinical profile, risk factors and prognosis are different from that in older patients.
Method: The present study is an attempt to evaluate acute myocardial infarction in young individuals (<40 years of age) undergoing coronary angiography (CAG). A total of 290 patients aged 40 years or younger who underwent CAG in the Department of Cardiology, Coimbatore medical college hospital between December 2019 to February 2021 were included in this study. Demographic characteristics, risk factor profile, laboratory test results, ECG and echocardiographic findings, CAG findings, and in-hospital mortality were assessed. All subjects completed the Hospital Anxiety and Depression Scale (HADS) to assess anxiety levels or presence of depressive symptoms as a potential risk factor among young patients.
Results: The mean patient age was 35.6 ± 4.4 years. Men made up 87.2% of the study sample. STEMI was present in 84 % of acute MI while remaining had NSTEMI. CHF (Killip class II or III) was present at hospital admission 14.4% patients. Angiographically normal coronary arteries were found in 4% of patients with the diagnosis of ACS. The most common location of significant atherosclerotic coronary lesions was the left anterior descending artery (60.1%) followed by the right coronary artery (32.4%). The most prevalent were conventional cardiovascular risk factors followed by anxiety/depression, a family history of CAD. The findings showed that 32% of the respondents had anxiety caseness and 40% had depression caseness.
Conclusion: Significant risk of CHF on presentation and STEMI most common cases. Modifiable risk factors constitute primary etiology with less commonly evaluated cause as anxiety and depression need to be monitored regularly, provide regular counselling services. 4.0% revealing normal coronaries suggesting microvascular dysfunction important process other than atherosclerosis.
Keywords: [young MI, nonconventional risk factors, STEMI, coronary angiogram]