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KMID : 0882420120820020175
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Korean Journal of Medicine
2012 Volume.82 No. 2 p.175 ~ p.184
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Comparison of Clinical Outcomes between ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Myocardial Infarction in Patients Younger Than 40 Years Who Underwent Percutaneous Coronary Artery Intervention
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Kim Nam-Yoon
Park In-Hyae
Jeong Myung-Ho
Lee Sook-Ja
Kim Dong-Han
Lee Ki-Hong
Lee Min-Goo
Sim Doo-Sun
Park Keun-Ho
Yoon Nam-Sik
Yoon Hyun-Ju
Kim Kye-Hun
Hong Young-Joon
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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Backgrounds/Aims:The prevalence of coronary artery disease has increased in young adults. We evaluated the differences in clinical characteristics and clinical outcomes in young patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).
Methods:A total of 164 patients with acute myocardial infarction who underwent percutaneous coronary intervention were divided into two groups: the STEMI group (120 patients; mean age, 35.7 ± 3.8 years; 118 males) and the NSTEMII group (44 patients; mean age, 35.7 ± 4.3 years; 43 males). We analyzed clinical and angiographic characteristics and major adverse cardiac events (MACE), including death from any cause, non-fatal myocardial infarction, target lesion revascularization, and coronary artery bypass graft surgery, during a 1-year clinical follow-up of the two groups.
Results:During hospitalization, Killip class II acute myocardial infarction (5.8% vs. 15.9%, p = 0.041) was observed more frequently in the NSTEMI group. The levels of troponin-I (66.9 ± 103.6 vs. 26.6 ± 38.5 ng/mL, p = 0.014) and N-terminal pro-brain natriuretic peptide (733.0 ± 1,018.1 vs. 476.2 ± 374.5 pg/mL, p = 0.012) were significantly higher in the STEMI group. One-year MACE did not differ between the two groups. By multiple logistic regression analysis, bare metal stents (odds ratio, 3.360; 95% confidence interval, 1.105-10.217; p = 0.033) and high lipoprotein (a) levels (odds ratio, 1.047; 95% confidence interval, 1.020-1.075; p = 0.001) were independent predictors of 1-year MACE.
Conslusions:Young patients with STEMI and NSTEMI have similar clinical outcomes. Bare metal stents and high serum lipoprotein (a) levels are independent predictors of MACE during 1-year clinical follow-ups in young patients with acute myocardial infarction.
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KEYWORD
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Myocardial infarction, Stents, Prognosis
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