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

Abstract

Introduction:Myocardial infarction remains a major cause of morbidity and mortality in the young population. The relationship between carotid intima-media thickness (CIMT) and atherosclerosis has been shown in many studies, however, there is no study investigating the association between carotid imaging and cardiovascular events in young patients. In our study, we evaluated the carotid imaging of young patients who experienced ST-elevated myocardial infarction (STEMI) and individuals at the same age and with normal coronary arteries.Methods:A total of 160 young patients were enrolled in the study. Of them, 115 patients were under the age of 45 years with STEMI and 45 were under the age of 45 years with normal coronary arteries shown in the coronary angiography. Carotid ultrasound was performed for all patients and they were divided into high-risk and low-risk carotid image groups according to CIMT and the presence of carotid plaque. Both groups were compared according to the traditional risk factors and the predictors of STEMI were investigated.Results:Both CIMT (0.87±0.28, vs 0.70±0.16, p<0.001) and the presence of carotid plaque (14.8% vs 2.2%, p=0.024) were found to be significantly higher in young patients with STEMI compared to the control group. Independently from other traditional risk factors, 0.1 mm increase in CIMT was associated with a 42% increase in odds for STEMI. Similarly, being in the high-risk carotid image group had 9.2 times increased odds for STEMI than being in the low-risk carotid image group.Conclusion:CIMT and the presence of carotid plaque have a predictive value for cardiovascular events in young age independently from traditional risk factors.

Keywords

• Myocardial infarction
• carotid intima-media thickness
• young age
• carotid plaque
• subclinical atherosclerosis