Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry)

Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University, New York, New York, USA.

OBJECTIVES. This study examined the angiographic characteristics, coronary risk factors and prognosis in young men and women with a history of myocardial infarction compared with that in older patients. BACKGROUND. There are few data regarding myocardial infarction in young adults. It is undetermined whether the development of myocardial infarction at a young age represents a form of coronary heart disease with an adverse prognosis. METHODS. Of the 8,839 patients with a history of myocardial infarction in the Coronary Artery Surgery Study (CASS), there were 294 men < or = 35 years old and 210 women < or = 45 years old. Coronary anatomy, baseline characteristics and prognosis were compared in younger and older patients. RESULTS. Young men and women more often had angiographically normal coronary arteries, nonobstructive disease < 70% stenosis and single-vessel disease than older patients (p < 0.0001). Current smoking was more frequent in young patients (p < 0.0001). Hypertension and diabetes were more frequent in both older men and women, whereas a positive family history of premature coronary disease was significantly more prevalent only in young men. The survival rate at 7 years was improved for young men compared with that in older men (84% vs. 75%, p = 0.0094) and for young women compared with that in older women (90% vs. 77%, p = 0.0004). When multivariate analysis was applied to the data, the survival advantage for young patients remained after adjustment. CONCLUSIONS. Young patients with a myocardial infarction have a favorable prognosis compared with that in older patients.

This article has been cited by other articles:

				P. Medina, S. Navarro, J. Corral, E. Zorio, V. Roldan, A. Estelles, A. Santamaria, F. Marin, J. Rueda, R. M. Bertina, et al. Endothelial protein C receptor polymorphisms and risk of myocardial infarction Haematologica, September 1, 2008; 93(9): 1358 - 1363. [Abstract] [Full Text] [PDF]

				C. Rao, O. Aziz, S. S. Panesar, C. Jones, S. Morris, A. Darzi, and T. Athanasiou Cost effectiveness analysis of minimally invasive internal thoracic artery bypass versus percutaneous revascularisation for isolated lesions of the left anterior descending artery BMJ, March 24, 2007; 334(7594): 621 - 621. [Abstract] [Full Text] [PDF]

				G. L. Gierach, B. D. Johnson, C. N. Bairey Merz, S. F. Kelsey, V. Bittner, M. B. Olson, L. J. Shaw, S. Mankad, C. J. Pepine, S. E. Reis, et al. Hypertension, Menopause, and Coronary Artery Disease Risk in the Women's Ischemia Syndrome Evaluation (WISE) Study J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S50 - S58. [Abstract] [Full Text] [PDF]

				M Egred, G Viswanathan, and G K Davis Myocardial infarction in young adults Postgrad. Med. J., December 1, 2005; 81(962): 741 - 745. [Abstract] [Full Text] [PDF]

				R. Sicari, A. Palinkas, E. G. Pasanisi, L. Venneri, and E. Picano Long-term survival of patients with chest pain syndrome and angiographically normal or near-normal coronary arteries: the additional prognostic value of dipyridamole echocardiography test (DET) Eur. Heart J., October 2, 2005; 26(20): 2136 - 2141. [Abstract] [Full Text] [PDF]

				A. Repetto, B. D. Bello, M. Pasotti, M. Agozzino, M. Vigano, C. Klersy, L. Tavazzi, and E. Arbustini Coronary atherosclerosis in end-stage idiopathic dilated cardiomyopathy: an innocent bystander? Eur. Heart J., August 1, 2005; 26(15): 1519 - 1527. [Abstract] [Full Text] [PDF]

				G. Logroscino and R. B. Lipton Migraine is associated with chest symptoms but not cardiac events: A reassuring paradox Neurology, December 28, 2004; 63(12): 2209 - 2210. [Full Text] [PDF]

				M. M. Fernandez, J. J. Rodriguez Reguero, and P. Gonzalez Angiotensin-converting enzyme polymorphism (I/D) and coronary heart disease in young adults J. Am. Coll. Cardiol., November 19, 2003; 42(10): 1864 - 1864. [Full Text] [PDF]

				S. E. Bojesen, K. Juul, P. Schnohr, A. Tybjaerg-Hansen, and B.o. G. Nordestgaard Platelet glycoprotein IIb/IIIa PlA2/PlA2 homozygosity associated with risk of ischemic cardiovascular disease and myocardial infarction in young men: The Copenhagen City Heart Study J. Am. Coll. Cardiol., August 20, 2003; 42(4): 661 - 667. [Abstract] [Full Text] [PDF]

				A A Awad-Elkarim, J P Bagger, C J Albers, J S Skinner, P C Adams, and R J C Hall A prospective study of long term prognosis in young myocardial infarction survivors: the prognostic value of angiography and exercise testing Heart, August 1, 2003; 89(8): 843 - 847. [Abstract] [Full Text] [PDF]

				Atherosclerosis, Thrombosis, and Vascular Biology No Evidence of Association Between Prothrombotic Gene Polymorphisms and the Development of Acute Myocardial Infarction at a Young Age Circulation, March 4, 2003; 107(8): 1117 - 1122. [Abstract] [Full Text] [PDF]

				J. H. Cole, J. I. Miller III, L. S. Sperling, and W. S. Weintraub Long-term follow-up of coronary artery disease presenting in young adults J. Am. Coll. Cardiol., February 19, 2003; 41(4): 521 - 528. [Abstract] [Full Text] [PDF]

				B. Salobir, M. Sabovic, P. Peternel, and M. Stegnar Fibrinolytic Parameters and Lipoprotein(a) in Young Women with Myocardial Infarction Angiology, March 1, 2002; 53(2): 157 - 163. [Abstract] [PDF]

				A Da Costa, K Isaaz, E Faure, S Mourot, A Cerisier, and M Lamaud Clinical characteristics, aetiological factors and long-term prognosis of myocardial infarction with an absolutely normal coronary angiogram; a 3-year follow-up study of 91 patients Eur. Heart J., August 2, 2001; 22(16): 1459 - 1465. [Abstract] [PDF]

				P. Ammann, S. Marschall, M. Kraus, L. Schmid, W. Angehrn, R. Krapf, and H. Rickli Characteristics and Prognosis of Myocardial Infarction in Patients With Normal Coronary Arteries Chest, February 1, 2000; 117(2): 333 - 338. [Abstract] [Full Text] [PDF]

				D. Ardissino, P.M. Mannucci, P.A. Merlini, F. Duca, R. Fetiveau, L. Tagliabue, M. Tubaro, M. Galvani, F. Ottani, M. Ferrario, et al. Prothrombotic Genetic Risk Factors in Young Survivors of Myocardial Infarction Blood, July 1, 1999; 94(1): 46 - 51. [Abstract] [Full Text] [PDF]

				A. Inbal, D. Freimark, B. Modan, A. Chetrit, S. Matetzky, N. Rosenberg, R. Dardik, Z. Baron, and U. Seligsohn Synergistic Effects of Prothrombotic Polymorphisms and Atherogenic Factors on the Risk of Myocardial Infarction in Young Males Blood, April 1, 1999; 93(7): 2186 - 2190. [Abstract] [Full Text] [PDF]

				A K Nightingale, C J Burrell, and A J Marshall Anomalous origin of the left coronary artery from the pulmonary artery: natural history and normal pregnancies Heart, December 1, 1998; 80(6): 629 - 631. [Abstract] [Full Text]

				A. J. Taylor, A. Farb, M. Ferguson, and R. Virmani Myocardial Infarction Associated With Physical Exertion in a Young Man Circulation, November 4, 1997; 96(9): 3201 - 3204. [Full Text]

				A. Schmermund, D. Baumgart, G. Gorge, R. Seibel, D. Gronemeyer, J. Ge, M. Haude, J. Rumberger, and R. Erbel Coronary Artery Calcium in Acute Coronary Syndromes : A Comparative Study of Electron-Beam Computed Tomography, Coronary Angiography, and Intracoronary Ultrasound in Survivors of Acute Myocardial Infarction and Unstable Angina Circulation, September 2, 1997; 96(5): 1461 - 1469. [Abstract] [Full Text]

				F.R. Rosendaal, D.S. Siscovick, S.M. Schwartz, B.M. Psaty, T.E. Raghunathan, and H.L. Vos A Common Prothrombin Variant (20210 G to A) Increases the Risk of Myocardial Infarction in Young Women Blood, September 1, 1997; 90(5): 1747 - 1750. [Abstract] [Full Text] [PDF]

				J. M. Edelberg, S. H. Lee, M. Kaur, L. Tang, N. M. Feirt, S. McCabe, O. Bramwell, S. C. Wong, and M. K. Hong Platelet-Derived Growth Factor-AB Limits the Extent of Myocardial Infarction in a Rat Model: Feasibility of Restoring Impaired Angiogenic Capacity in the Aging Heart Circulation, February 5, 2002; 105(5): 608 - 613. [Abstract] [Full Text] [PDF]