Document Detail


Acute coronary syndromes in young patients: presentation, treatment and outcome.
MedLine Citation:
PMID:  19942306     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Acute coronary syndromes (ACS) in very young patients have been poorly described. We therefore evaluate ACS in patients aged 35 years and younger.
METHODS: In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).
RESULTS: 195 patients (0.7%) were 35 years old or younger. Compared to patients>35 years, these patients were more likely to present with chest pain (91.6% vs. 83.7%; P=0.003) and less likely to have heart failure (Killip class II to IV in 5.2% vs. 23.0%; P<0.001). STEMI was more prevalent in younger than in older patients (73.1% vs. 58.3%; P<0.001). Smoking, family history of CAD, and/or dyslipidemia were important cardiovascular risk factors in young patients (prevalence 77.2%, 55.0%, and 44.0%). The prevalence of overweight among young patients with ACS was high (57.8%). Cocaine abuse was associated with ACS in some young patients. Compared to older patients, young patients were more likely to receive early percutaneous coronary interventions and had better outcome with fewer major adverse cardiac events.
CONCLUSIONS: Young patients with ACS differed from older patients in that the younger often presented with STEMI, received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.
Authors:
Andreas W Schoenenberger; Dragana Radovanovic; Jean-Christophe Stauffer; Stephan Windecker; Philip Urban; Gregor Niedermaier; Pierre-Frédéric Keller; Felix Gutzwiller; Paul Erne;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-26
Journal Detail:
Title:  International journal of cardiology     Volume:  148     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  300-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Geriatrics and General Internal Medicine, University of Berne Hospital Inselspital, Institute of Social and Preventive Medicine, University of Berne, Berne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Investigator
Investigator/Affiliation:
P Erne / ; O Bertel / ; F Eberli / ; P-F Keller / ; M Maggiorini / ; G Pedrazzini / ; H Rickli / ; J-C Stauffer / ; P Urban / ; F Hess / ; R Simon / ; P J Hangartner / ; M Rhyner / ; P Lessing / ; M Neuhaus / ; U Hufschmid / ; P Hunziker / ; C Grädel / ; A Schönfelder / ; B Meier / ; S Windecker / ; H Schläpfer / ; D Evéquoz / ; R Pampaluchi / ; A Ciurea-Löchel / ; A Vögele / ; D Ryser / ; V Wüscher / ; R Jecker / ; G Niedermaier / ; A Koelz / ; H Lederer / ; S Stäuble / ; T Langenegger / ; J Haarer / ; H P Schmid / ; B Quartenoud / ; S Moser / ; K Bietenhard / ; J M Gaspoz / ; P-F Keller / ; W Wojtyna / ; P Schlup / ; A Oestmann / ; B Oertli / ; R Schönenberger / ; C Simonin / ; R Waldburger / ; P Staub / ; M Schmidli / ; P Sula / ; E M Weiss / ; H Marty / ; H Zender / ; I Poepping / ; C Steffen / ; J Sollberger / ; A Hugi / ; E Koltai / ; G Pedrazzini / ; P Erne / ; J von Meyenburg / ; T Luterbacher / ; B Jordan / ; A Pagnamenta / ; P Urban / ; P Feraud / ; E Beretta / ; C Stettler / ; F Repond / ; F Widmer / ; A Spillmann / ; F Scheibe / ; K Rudaz-Schwaller / ; R Polikar / ; S Bassetti / ; H U Iselin / ; A Fischer / ; P Egger / ; T Kaeslin / ; R Frey / ; B Risti / ; V Stojanovic / ; T Herren / ; P Eichhorn / ; G Flury / ; C Neumeier / ; P Hilti / ; A Grât / ; R Schönenberger / ; W Angehrn / ; H Rickli / ; S Yoon / ; P Loretan / ; U Stoller / ; U P Veragut / ; A Weber / ; G Garzoli / ; B Kälin / ; H Matter / ; D Schiesser / ; A Haller / ; M Peter / ; H J Vonesch / ; S Gasser / ; P Siegrist / ; R Fatio / ; O Bertel / ; F Eberli / ; M Maggiorini / ; O Bertel / ; F Eberli / ; M Brabetz / ; S Christen / ; F Gutzwiller / ; M Essig / ; P Hunziker / ; M Kruhl / ; P Müller / ; M Pfister / ; D Maurer / ; J Muntwyler / ; J Hellermann / ; M Graber / ; H J Meier / ; M Vogt / ; D Ramsay /

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