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To evaluate the clinical characteristics, clinical outcomes during hospitalization and the forward major adverse cardiovascular events (MACE) of young patients (≤40 years of age) with acute myocardial infarction (AMI) in different genders. Disscuss risk factors of adverse clinical events.
Patiens from 2012-01-01 to 2015-08-31 in Beijing anzhen hospital diagnosed with AMI (≤40 years old) are accepted, 685 cases of patients. We divided the patients into two groups on the basis of gender. Clinical data of two groups of patients was collected and compared, including baseline data, laboratory and imaging examination and adverse events at hospital period. Follow-up data were collected by telephone communications. Risk factors of MACE were identified by Cox proportional-hazards model.
Young male patients with AMI were much morer than females, male group show an older average age [(35.53+4.21) years old] than female group [(34.05+4.98) years old](P < 0.05); Proportion of left main diseases (LMD), incidence of acute heart failure in hospital period in male group is lower than female group[(3.2% vs 11.4%, P<0.05); (8.3% vs 25.7%, P < 0.05)]; Patients were followed up for a median of 727.0(411.5, 1102.0) days. In the male group and the female group, the MACE incidence was 46(7.1%) and 2(5.7%), respectively. There was no obvious statistical significance difference (P=0.758). Independent risk factors of long term MACE were hs-TnI (OR: 0.003, 95%CI: 1.001∼1.006, P=0.020) and Multivessle disease (OR:: 1.964, 95%CI: 1.018∼3.790, P=0.044); The protective factors is percutaneous coronary intervention(PCI)(OR=0.475, 95%CI: 0.241∼0.936, P=0.031) by multivariate cox analysis.
There was a predominance of men in patients under 40 with AMI, and the average age of male group is higher. Female patients are more vulnerable to left main coronary artery and acute heart failure at the time of hospitalization. Increase in the concentration of hs-TnI or MVD would indicate poor outcome, and PCI seems to be a beneficial option for male patients.