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KMID : 0368120150450040275
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Korean Circulation Journal
2015 Volume.45 No. 4 p.275 ~ p.284
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Clinical Characteristics and Outcomes of Acute ST-Segment Elevation Myocardial Infarction in Younger Korean Adults
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Lee Seung-Hun
Kim Ju-Han
Jeong Myung-Ho
Park Hyuk-Jin
Jeong Yun-Ah
Ahn Young-Keun
Kim Jong-Hyun
Chae Shung-Chull
Kim Young-Jo
Hur Seung-Ho
Seong In-Whan
Hong Taek-Jong
Choi Dong-Hoon
Cho Myeong-Chan
Kim Chong-Jin
Seung Ki-Bae
Seung Ki-Bae
Chung Wook-Sung
Jang Yang-Soo
Cho Jeong-Gwan
Park Jong-Chun
Park Seung-Jung
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Abstract
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Background and Objectives: This study aims to investigate the clinical features, angiographic findings, and outcomes of younger Korean ST-segment elevation myocardial infarction (STEMI) patients.
Subjects and Methods: We analyzed major adverse cardiac events (MACE) in the Korea Acute Myocardial Infarction Registry from November 2005 to October 2010. The registered patients were divided into two groups; young age group (<65 years) and old age group (≥65 years).
Results: The young age group included 5281 patients (age, 53±7.8 years), and the old age group included 4896 patients (age, 74.3±6.5 years). Male gender, smoking, family history, dyslipidemia, and metabolic syndrome were more frequently observed in the young age group than in the old age group (89.5% vs. 59.3%, p<0.001; 77.3% vs. 47.2%, p<0.001; 11% vs. 4.6%, p<0.001; 11.2% vs. 7.7%, p<0.001; 67.6% vs. 62.9%, p<0.001). Most of the young Korean adults with STEMI complained of typical chest pain (89.8%), and they had a shorter symptom-to-door time (12±53.2 hours vs. 17.3±132 hours, p=0.010). The young age group showed a favorable prognosis, which was represented by the MACE, compared with the old age group at one month (1.8% vs. 2.8%, p=0.028), six months (6.8% vs. 8.2%, p<0.001), and twelve months (10.1% vs. 11.9%, p=0.025). However, there was no significant difference in the adjusted MACE rate at one month {hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.60-1.51, p=0.828} and twelve months (HR 0.86, 95% CI 0.68-1.10, p=0.233).
Conclusion: Younger Korean adults with STEMI have clinical outcomes similar to old aged patients, and therefore, they should be treated intensively like the elderly patients.
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KEYWORD
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Myocardial infarction, Young adult, Prognosis
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