Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore
- PMID: 22761974
- PMCID: PMC3386311
- DOI: 10.4330/wjc.v4.i6.206
Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore
Abstract
Aim: 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.
Conclusion: 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.
Keywords: Clinical features; Myocardial infarction; Outcomes; Southeast asia; Young.
Figures
References
-
- Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young patients: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry) J Am Coll Cardiol. 1995;26:654–661. - PubMed
-
- Kanitz MG, Giovannucci SJ, Jones JS, Mott M. Myocardial infarction in young adults: risk factors and clinical features. J Emerg Med. 1996;14:139–145. - PubMed
-
- Moccetti T, Malacrida R, Pasotti E, Sessa F, Genoni M, Barlera S, Turazza F, Maggioni AP. Epidemiologic variables and outcome of 1972 young patients with acute myocardial infarction. Data from the GISSI-2 database. Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI-2) Arch Intern Med. 1997;157:865–869. - PubMed
-
- Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, Eagle K. Acute myocardial infarction in the young--The University of Michigan experience. Am Heart J. 2002;143:56–62. - PubMed
-
- Choudhury L, Marsh JD. Myocardial infarction in young patients. Am J Med. 1999;107:254–261. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials
