Acute myocardial infarction in young Bangladeshis: A comparison with older patients

AimYoungs with AMI may have unique risk factor, angiographic profile and outcome compared with older.MethodsProfile of 183 young patients (age ≤40 yrs) with AMI admitted to the CCU of Chittagong Medical College Hospital, Bangladesh in one year were compared with 168 older patients of age ≥40 years (range 41–70 yrs). Location and types of AMI were determined by ECG and serum troponin- I. Blood for fasting glucose, lipid and a hs-CRP were drawn within 24 hours of admission. CAG was done within 6 weeks of hospital discharge.ResultAge range of 183 young patients were 21–40 yrs (average 34.21 ± 5.07 yrs). There were 157 male (85.5%) and 26 (14.2%) female (M:F = 6.03:1). Family history of CAD was more common in young (28.6% vs 19.8%, p < 0.01). More young patients were smoker (64.5% vs 59.4%, p < 0.05). Dyslipidaemia was found more among young (49.7% vs 38.8%, p < 0.01). A previous history of angina and MI was less often in younger (17.4% vs 26.7% and 9.2% vs 26.1% respectively).A raised hs-CRP was found more frequently in young (43.6% vs 17.3%, p < 0.001). In-hospital mortality was only 3.2% in young compared with 10.7% in older (p < 0.01). Echocardiography revealed a lower ejection fraction in the older patients (0.48 ± 0.15 vs 0.51 ± 0.13). CAG revealed lesser degree of coronary lesions in youngs and a higher multivessel CAD among the older.ConclusionYoung patients presented lately with more dyslipidaemia, positive family history, raised hs-CRP, smoking and had a better in-hospital outcome. Less severe angiographic lesion suggest that early percutaneous coronary interventions may be beneficial.