Epidemiological Features and Clinical Presentations of Acute Coronary Syndrome in Young Patients
Epidemiological Features and Clinical Presentations of Acute Coronary Syndrome in Young Patients
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DOI：
10.2169/internalmedicine.4138-19
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发表时间：
2020-02
影响因子：
1.2
通讯作者：
Hiroaki Sawada;H. Ando;H. Takashima;K. Waseda;Masahiro Shimoda;Hirofumi Ohashi;A. Suzuki;S. Sakurai;Y. Nakano;T. Amano
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文献类型：
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作者：
Hiroaki Sawada;H. Ando;H. Takashima;K. Waseda;Masahiro Shimoda;Hirofumi Ohashi;A. Suzuki;S. Sakurai;Y. Nakano;T. Amano
目的急性冠状动脉综合征（acute coronary syndrome，ACS）在年轻患者中并不常见，但由于其对年轻患者积极的生活方式的破坏性影响，ACS已成为一个重要的问题。目前，还没有关于预防年轻患者ACS的指南。方法我们对2014年至2017年期间的ACS患者进行了回顾性研究。对年轻ACS患者（≤50岁）和老年ACS患者（>50岁）的流行病学数据、临床表现和短期结局进行了评价。结果361例ACS患者中，青年ACS患者37例（10.2%）。与老年ACS患者相比，年轻ACS患者的男性患病率（94.6% vs. 73.8%，p<0.001）、当前吸烟率（70.3% vs. 29.9%; p<0.001）和超重者患病率（67.6% vs. 27.8%，p<0.001）更高。年轻ACS患者的二十碳五烯酸（EPA）/花生四烯酸（AA）比值显著低于老年ACS患者[0.17（0.12-0.25）vs. 0.25（0.18-0.37），p=0.002]。年轻ACS患者的心肺骤停和经皮心肺支持使用率高于老年ACS患者（24.3% vs. 8.6%，p=0.003，16.2% vs. 3.1%，p<0.001）。结论青年ACS患者与老年ACS患者有明显不同的临床特点。在年轻ACS患者中，吸烟、超重和低EPA/AA比率是独特的危险因素，并且在ACS发作时观察到比老年患者更严重的临床表现。
Objective Although acute coronary syndrome (ACS) is an uncommon entity in young patients, it constitutes an important problem due to the devastating effects of the disease on the more active lifestyle of young patients. At present, there are no guidelines regarding the prevention of ACS in young patients. Methods We performed a retrospective study of ACS patients between 2014 and 2017. Epidemiological data, clinical findings, and short-term outcomes were evaluated between young ACS patients (≤50 years old) and elderly ACS patients (>50 years old). Results Of a total of 361 consecutive ACS patients, 37 were young ACS patients (10.2%). Compared with elderly ACS patients, young ACS patients showed a higher prevalence of males (94.6% vs. 73.8%, p<0.001), current smoking (70.3% vs. 29.9%; p<0.001), and overweight persons (67.6% vs. 27.8%, p<0.001). The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio was significantly lower in young ACS patients than in elderly ACS patients [0.17 (0.12-0.25) vs. 0.25 (0.18-0.37), p=0.002]. The prevalence of cardio-pulmonary arrest and percutaneous cardiopulmonary support use was higher in young ACS patients than in elderly ACS patients (24.3% vs. 8.6%, p=0.003, 16.2% vs. 3.1%, p<0.001). Conclusion The features were markedly different between young ACS patients and elderly ACS patients. In young ACS patients, smoking, being overweight, and a low EPA/AA ratio were distinctive risk factors, and more serious clinical presentations were observed at the onset of ACS than in older patients.