More favorable long-term outcome after discharge in young adults with myocardial infarction

Chung, Bo Young; Ha, Jong Won; Jang, Yang Soo; Choi, Dong Hoon; Ahn, Shin Ki; Rim, Se Jong; Chung, Nam Sik; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon

Abstract

BACKGROUND: The purpose of this study was to evaluate risk factors, angiographic characteristics and long-term prognosis of young adults with myocardial infarction(MI).
METHODS
Of the 2,680 patients with a history of MI, there were 148 patients 40 years old(Group 1). Risk factors, angiographic characteristics, cardiac events and long-term prognosis of group 1 were compared with those of randomly selected 149 patients between 41 years to 70 years old(Group 2) for a mean follow-up duration of 38 months(1-147 months). Cardiac events include death, reinfarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, congestive heart failure, stroke, and angina.
RESULTS
Smoker and male gender were more frequent in group 1(p<0.001). In group 2, hypertension and diabetes were more frequently observed(p<0.001). Angiographically normal coronary arteries, nonobstructive disease(<70% stenosis) and single-vessel disease were more frequent in group 1 than those in group 2 (p<0.001). There was no significant difference of overall survival at 7 years between the two groups(group 1; 95%, group 2; 89%, p>0.05). If hospital deaths were excluded, the 7-year survival was better in group 1(group 1; 99%, group 2; 92%, p<0.01). The cardiac event free survial at 7 years was not different between two groups(p>0.05). Although a better left ventricular(LV) systolic function (ejection fraction(EF) 40%) showed more favorable survival in group 2(EF40%: 94%, EF<40%: 80%, p<0.05), survival was not influenced by LV systolic function in group 1.
CONCLUSION
Young patients with MI have a more favorable long-term survival after discharge compared with that of the older patients regardless of LV systolic function. Cardiac event free survival was, however, not different between two groups.