title: Acute myocardial infarction in patients aged under 45 years.
abstract: BACKGROUND
  Coronary artery disease (CAD) becomes an important cause of morbidity and mortality after the age of 45 years.
  
  
  OBJECTIVE
  To evaluate the epidemiology and clinical features of all patients under 45 years old admitted with myocardial infarction.
  
  
  METHODS
  We studied 595 patients admitted with myocardial infarction between January 2000 and December 2002. We analyzed risk factors for CAD, clinical profile, therapeutics and complications (arrhythmic, mechanical and ischemic). The patients were divided into two groups: A--under 45 years old and B-- aged 45 or over.
  
  
  RESULTS
  Group A--56 patients (9.4%); group B--539 patients (90.6 %). There was a higher prevalence of smoking in group A (57% vs. 23.6%; p < 0.01). Hypertension, diabetes and history of CAD were significantly more common in group B. There were no differences in hyperlipidemia (group A: 43% vs. group B: 43.5%). Fibrinolysis was performed in 28 patients (70%) from group A compared to 40 patients (45.9%; p < 0.01) from group B. Use of digitalis and inotropic agents was greater in group B. No differences were found in other pharmacological therapeutics. We found more complications in group B (24% vs. 11%).
  
  
  CONCLUSIONS
  There was a higher prevalence of smoking in patients under 45 years old and of hypertension, diabetes and CAD in patients aged over 45. The high rate of hyperlipidemia in both groups highlights the importance of primary prevention. Fibrinolysis was performed more frequently in younger patients. There were more complications in older patients.
authors.affiliation: Serviço de Cardiologia do Hospital de São Bernardo, Setúbal, Portugal. nuno.fonseca@netvisao.pt
authors.forename: Nuno
authors.initials: N
authors.lastname: Fonseca
authors.forename: Leonel
authors.initials: L
authors.lastname: Bernardino
authors.forename: Isabel
authors.initials: I
authors.lastname: Silvestre
authors.forename: José
authors.initials: J
authors.lastname: Santos
authors.forename: Filipe
authors.initials: F
authors.lastname: Seixo
authors.forename: Lígia
authors.initials: L
authors.lastname: Mendes
authors.forename: Lopes
authors.initials: L
authors.lastname: Inês
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies