[Clinical manifestations and outcome of acute myocardial infarction in young adults treated with primary coronary angioplasty].
OBJECTIVE
This study investigated the differences in presentation, complications, and outcome of young patients with acute myocardial infarction compared to other patients.


METHODS
Our series of 379 consecutive patients with acute myocardial infarction, who were admitted within 12 hr of onset and successfully reperfused by primary percutaneous coronary intervention, included 28 (7.4%) young patients (< 50 years).


RESULTS
There were significantly more male patients, current smokers, and hyperlipidemia in the young group than in the other patients (p < 0.01). The levels of acute phase brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) were significantly lower (BNP: 128 +/- 103 vs 379 +/- 470 pg/ml, p = 0.009, ANP: 17 +/- 11 vs 66 +/- 81 pg/ml, p = 0.004) and peak creatine kinase value was significantly higher (3,824 +/- 3,459 vs 2,413 +/- 2,023 IU/l, p = 0.009) in the young group than in the other patients. The increase (chronic phase-acute phase) of left ventricular ejection fraction was significantly better in the young group (8 +/- 9% vs 4 +/- 10%, p < 0.05). There were significantly fewer patients with ventricular arrhythmia in the young group than in the other patients (10.7% vs 33.0%, p = 0.04). The cardiac mortality rate in the first 6 months was only 3.6% in the young group.


CONCLUSIONS
Young patients with acute myocardial infarction, in spite of higher peak creatine kinase value, seemed to have excellent prognosis, with lower BNP and good recovery of left ventricular ejection fraction.
Katayama
Toshiro
T
Department of Cardiology, Nagasaki Kouseikai Hospital, Akahaku 2-5-5-1615, Nagasaki, Nagasaki 852-8156. snowman-kt@syd.odn.ne.jp
Iwasaki
Yoshihiro
Y
Yamamoto
Tadashi
T
Yoshioka
Masato
M
Nakashima
Hiroshi
H
Suzuki
Shin
S
Yano
Katsusuke
K
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D012907:Smoking / Q000503:physiopathology; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form