Acute coronary syndromes in young patients: presentation, treatment and outcome.
Details
Serval ID
serval:BIB_66196C353953
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute coronary syndromes in young patients: presentation, treatment and outcome.
Journal
International Journal of Cardiology
Working group(s)
AMIS Plus Investigators
Contributor(s)
Erne P., Bertel O., Eberli F., Keller PF., Maggiorini M., Pedrazzini G., Rickli H., Stauffer JC., Urban P., Hess F., Simon R., Hangartner PJ., Rhyner M., Lessing P., Neuhaus M., Hufschmid U., Hunziker P., Grädel C., Schönfelder A., Meier B., Windecker S., Schläpfer H., Evéquoz D., Pampaluchi R., Ciurea-Löchel A., Vögele A., Ryser D., Wüscher V., Jecker R., Niedermaier G., Koelz A., Lederer H., Stäuble S., Langenegger T., Haarer J., Schmid HP., Quartenoud B., Moser S., Bietenhard K., Gaspoz JM., Keller PF., Wojtyna W., Schlup P., Oestmann A., Oertli B., Schönenberger R., Simonin C., Waldburger R., Staub P., Schmidli M., Sula P., Weiss EM., Marty H., Zender H., Poepping I., Steffen C., Sollberger J., Hugi A., Koltai E., Pedrazzini G., Erne P., von Meyenburg J., Luterbacher T., Jordan B., Pagnamenta A., Urban P., Feraud P., Beretta E., Stettler C., Repond F., Widmer F., Spillmann A., Scheibe F., Rudaz-Schwaller K., Polikar R., Bassetti S., Iselin HU., Fischer A., Egger P., Kaeslin T., Frey R., Risti B., Stojanovic V., Herren T., Eichhorn P., Flury G., Neumeier C., Hilti P., Grât A., Schönenberger R., Angehrn W., Rickli H., Yoon S., Loretan P., Stoller U., Veragut UP., Weber A., Garzoli G., Kälin B., Matter H., Schiesser D., Haller A., Peter M., Vonesch HJ., Gasser S., Siegrist P., Fatio R., Bertel O., Eberli F., Maggiorini M., Bertel O., Eberli F., Brabetz M., Christen S., Gutzwiller F., Essig M., Hunziker P., Kruhl M., Müller P., Pfister M., Maurer D., Muntwyler J., Hellermann J., Graber M., Meier HJ., Vogt M., Ramsay D.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
2011
Volume
148
Number
3
Pages
300-304
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
BACKGROUND: Acute coronary syndromes (ACS) in very young patients have been poorly described. We therefore evaluate ACS in patients aged 35 years and younger.
METHODS: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).
RESULTS: 195 patients (0.7%) were 35 years old or younger. Compared to patients>35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; P<0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; P<0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events.
CONCLUSIONS: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.
METHODS: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).
RESULTS: 195 patients (0.7%) were 35 years old or younger. Compared to patients>35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; P<0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; P<0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events.
CONCLUSIONS: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.
Keywords
Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/physiopathology, Adult, Age Factors, Aged, Angina, Unstable/diagnosis, Angina, Unstable/physiopathology, Cohort Studies, Humans, Middle Aged, Myocardial Infarction/diagnosis, Myocardial Infarction/physiopathology, Prospective Studies, Treatment Outcome
Pubmed
Web of science
Create date
13/05/2011 9:20
Last modification date
20/08/2019 15:22
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