Clinical, Angiographic Profile and Short-term Prognosis in Patients with ST Elevation Myocardial Infarction- A Cross-sectional Study

Abstract

Introduction: Acute Myocardial Infarction (MI) is one of the most common causes of death and disability throughout the world. The most common of all Acute Coronary Syndrome (ACS) in Indian patients is acute ST Elevation Myocardial Infarction (STEMI). Although acute MI more commonly occurs in patients older than 45 years of age, young men and women can also have MI. Aim: To study the risk factors, clinical presentation, angiographic profile and short-term prognosis in patients with STEMI with age <45 years. Materials and Methods: A cross-sectional study was carried out in the Department of Cardiology, SCB Medical College and Hospital, Cuttack, Odisha, India. A total of 198 patients of age ≤45 years with acute STEMI, of both genders diagnosed based on symptoms, Electrocardiogram (ECG), Echocardiogram (Echo) and biomarkers were enrolled from June 2019 to November 2020. Categorical variables were tabulated in frequency with percentage distribution and continuous variables were summarised in mean±SD (Standard Deviation). Results: This study included 198 patients, aged ≤45 years, with STEMI. STEMI was more common in males. The mean age was 38.28 and 42.15 years for males and females, respectively. Smoking (63.5%) was the most common risk factor, followed by dyslipidemia (28.5%). Most of the patients (86.5%) presented with typical chest pain. Killip’s Class I was most common (92.5%) at the time of admission. Anterior Wall Myocardial Infarction (AWMI) was the presentation in the majority (61%). Most patients (47%) had Single Vessel Disease (SVD). One third of the patients had re-canalysed vessels. Type A lesion was commonly seen (61%) and 60% patients underwent coronary angioplasty. Conclusion: In young STEMI patients males were commoner and smoking and dyslipidemia were found to be the common risk factors, smoking being twice more common than dyslipidemia. Typical chest pain of Killip Class I and AWMI were seen in majority. Half of the patients had SVD and one third was found to be re-canalysed. Type A was the commonest lesion and two thirds of the study population could undergo coronary angioplasty.

Keywords

• acute coronary syndrome
• coronary artery disease
• young myocardial infarction