title: Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore.
abstract: OBJECTIVE
  To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore.
  
  
  METHODS
  Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes.
  
  
  RESULTS
  The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and high-density lipoprotein levels were 5.6 ± 1.2 mmol/L, 3.8 ± 1.1 mmol/L and 0.93 ± 0.25 mmol/L respectively. The mean left ventricular function was 44% ± 10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups.
  
  
  CONCLUSIONS
  Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI.
authors: Chun Pong Wong, Seet Yoong Loh, Kwok Kong Loh, Paul Jau Lueng Ong, David Foo, Hee Hwa Ho, Department of Cardiology, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors: Chun Pong
authors: CP
authors: Wong
authors: Seet Yoong
authors: SY
authors: Loh
authors: Kwok Kong
authors: KK
authors: Loh
authors: Paul Jau Lueng
authors: PJ
authors: Ong
authors: David
authors: D
authors: Foo
authors: Hee Hwa
authors: HH
authors: Ho