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40세 이하의 한국인에서 발생한 급성 심근경색증의 임상적 특성
조상철 ( Sang Cheol Cho ),정명호 ( Myung Ho Jeong ),김원 ( Weon Kim ),최옥자 ( Ok Ja Choi ),정안덕 ( An Doc Chung ),강원유 ( Won Yu Kang ),조용찬 ( Yong Chan Cho ),안영근 ( Young Keun Ahn ),김완 ( Wan Kim ) 대한내과학회 2008 대한내과학회지 Vol.74 No.5
Background/Aims: It is known that mortality increases with age for patients who suffer with acute myocardial infarction (AMI). Yet there isn`t much data on the clinical characteristics and long-term prognosis of young patients with AMI. Methods: We analyzed two groups of patients with AMI who underwent coronary angiogram: 108 patients younger than 40 years as group I and 64 patients over 70 years old as group II. We compared the baseline clinical characteristics, the echocardiographic and coronary angiographic findings, and the major adverse cardiac event (MACE). Results: Male gender (94.4% vs. 56.1%, respectively, p<0.001), smoking (78.7% vs. 46.9%, respectively, p<0.001) and hyperlipidemia (45.4% vs. 14.1%, respectively, p<0.001) were more frequent in group I, whereas hypertension (23.1% vs. 40.6%, respectively, p=0.015) and diabetes (11.6% vs. 34.4%, respectively, p<0.001) were more common in group II. The left ventricular ejection fraction (55.1±12.2% vs. 50.5±14.1%, respectively, p=0.042) was higher in group I. The serum levels of high sensitivity C-reactive protein (1.7±2.6 vs. 3.4±4.4 mg/L, respectively, p=0.015) and homocysteine (11.5±7.0 vs. 15.3±9.7 μg/L, respectively, p=0.029) were higher in group II. One vessel disease (78.7% vs. 59.4%, respectively, p=0.007) and good Thrombolysis In Myocardial Infarction (TIMI) flow (TIMI II-III, 58.3% vs. 41.2%, respectively, p=0.040) were more common in group 1. There were no differences between the two groups for the development of MACE during the 28±21 months of clinical follow-up, but cardiac death was lower in group I than in group II (2.1% vs. 15.4%, respectively, p=0.002). Conclusions: Male gender, smoking and hyperlipidemia were the major risk factors of Korean young AMI patients. In addition, single vessel disease and good TIMI flow were more frequent and cardiac death was less frequent in the younger AMI patients.(Korean J Med 74:515-522, 2008)
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