Profile of Young Acute Myocardial Infarction in Chittagong Medical College Hospital, Chittagong.
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Date
2011
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Abstract
Background: Coronary artery disease (CAD) is now an emerging epidemic in developing countries
including Bangladesh. Younger people are being affected here more and more. Young individuals
with acute myocardial infarction (AMI) may have unique presentation, risk factor, angiographic
profile and outcome which may have an influence on the preventive strategies. This study is an
attempt to investigate the same.
Methods: Young patients (aged d” 40 yrs) with AMI admitted to the coronary care unit of Chittagong
Medical College Hospital over a period of one year were included in the study. Assessments of the
patients were done with clinical history, physical examination and systemic evaluation. Location
and types (STEMI, NSTEMI) of myocardial infarction were determined by ECG and serum troponin-
1 assay. Blood for glucose and lipid profile was drawn within 24 hours of admission. High sensitivity
testing for C-reactive protein (hs CRP) was done in all patients. Coronary angiography was done
within 6 weeks of hospital discharge.
Results: A total of 83 Patients with age d” 40 years were included .Age range were 21-40 years (34.21
± 5.07 yrs). There were 71 male (85.5%). Male: female ratio was 5.9:1. Most of the young AMI patients
presented lately to the hospital. Majority of these patients were thinly built, came from urban or
semiurban areas, engaged in heavy physical activities and belonged to lower socioeconomic group.
A positive family history of CAD was present in 18 patients (28.68 %). Smoking was the most
prevalent risk factor followed by a raised serum triglyceride or low high density lipoprotein (HDL).
A raised hs CRP was present in 47 patients (49.39%). The overall in hospital mortality was only 3.61
%. Coronary angiography done in 38 patients revealed single vessel disease in the majority.
Conclusion: The study focuses our attention to the rising incidence of AMI in young individuals
who are less prone to CAD. Early detection of AMI and timely intervention needs high index of
suspicion in this age group. These young patients have got low BMI High TG, Low HDG High hs
CRP & habit of smoking. Avoidance of smoking, controlling high TG and/or low HDL may reduce
incidence of AMI among young patients. Use of high dose of statin at an early age in young persons
with raised CRP may be considered.
Description
Keywords
Myocardial infarction, Young
Citation
Das P K, Ghafur S, Bhattacharjee B, Dey A, Mollah A L, Kamal S M M, Murshed A K M M. Profile of Young Acute Myocardial Infarction in Chittagong Medical College Hospital, Chittagong. Cardiovascular Journal. 2011; 4(1): 53-57.