Different Clinical Presentations in Chinese People with Acute Myocardial Infarction in the Emergency Department

BackgroundThe purpose of this study was to investigate the clinical characteristics of younger- (≤45 years old) and older-aged (>45 years) Chinese patients presenting to the emergency department (ED) with an initial acute myocardial infarction (AMI).MethodsA retrospective review of 372 patients who had suffered an AMI (134 younger-aged, 238 older-aged), from 2,858 suspected AMI or ischemia patients during the period January 1996 to June 2003 inclusive, was conducted. Only patients who were diagnosed with AMI and who had been admitted to our institution's ED were enrolled into this study.ResultsThe incidence of AMI for individuals who were ≤ 45 years old was approximately 12.3% of those admitted to hospital under the impression of AMI. The percentage of males was more predominant in the younger-aged group (p<0.01). Regarding major risk factors for coronary artery disease (CAD), younger patients were more likely to have a family history of cardiac disease (p<0.01), obesity with an elevated body mass index (26.2 ±4.1 vs. 24.2 ± 3.7, p< 0.01), and hyperlipidemia (p<0.01) when compared to the older-aged patients, who were more likely to suffer from hypertension (p<0.01) and/or diabetes mellitus than their younger-aged counterparts (p<0.01). Younger patients also featured a higher incidence of single-vessel CAD (p = 0.05), an insignificant rate of CAD (p = 0.02), and a lower rate of triple-vessel CAD (p = 0.03).ConclusionFor Chinese, male gender and incidences of chest pain, positive family history of heart disease, obesity and hyperlipidemia were significantly greater in the younger-aged AMI patient group than in the older-aged AMI patient group. Younger-aged patients also had a greater rate of single-vessel CAD but a lower rate of triple-vessel CAD than older-aged patients.