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钱赓 副主任医师 301医院 心血管内科

中国青年心肌梗死临床特点以及预后影响因素分析

钱赓 副主任医师 301医院 心血管内科
发表于2018-02-13
人已读

Background: The proportion of the mainland Chinese population with premature ST-segment elevation myocardial

infarction is significantly elevated. Young patients with ST-segment elevation myocardial infarction have a different

risk factor profile and clinical outcome compared with elder patients, and may also differ as compared to young北京301医院心血管内科钱赓

patients in Western populations.

Methods: We analyzed a total of 9462 consecutive ST-segment elevation myocardial infarction patients, and

recruited 341 consecutive cases who had survived their first ST-segment elevation myocardial infarction at the age

less than 40 years, and followed-up these patients for 5 years.

Results: The most prevalent risk factor in young Chinese ST-segment elevation myocardial infarction patients was

smoking (307/341, 90.03%) and male gender (328/341, 96.19%), although young patients had fewer traditional risk

factors of acute myocardial infarction than the control group [(1.63 1.03) vs. (2.38 1.15), p < 0.01]. The number

of affected vessels in cases was significantly less than in the elder control group (p < 0.01). During the follow-up,

blood lipids and blood pressure of most patients reached the target level, while 42.10% of patients reported

continuation of smoking. Multivariable data analysis showed that persistence of smoking (OR: 3.784, 95% CI:

1.636-8.751, p < 0.01) was the most significant prognostic factor of cardiac events after adjusting for various

confounding factors.

Conclusions: We demonstrated that cigarette smoking is the most prevalent factor among the avoidable

cardiovascular risk factors for young ST-segment elevation myocardial infarctions in China. Accordingly, continued

smoking is the most powerful predictor for the recurrence of cardiac events in young Chinese patients with

ST-segment elevation myocardial infarction.

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