Akutni infarkt miokarda kod pacijenata do 45 godina starosti – šta se promenilo za 10 godina?

akutni infarkt miokarda

  • Assist. dr Danijela Djordjević Radojković Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija; Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • dr Midrag Damjanović Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija
  • Prof. dr Svetlana Apostolović Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija; Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • dr Jelena Milošević Klinika za kardiologiju Nis
  • dr Dragana Stanojević Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija
  • Prof. dr Goran Koraćević Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija; Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • dr Ružica Janković Tomašević Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija
  • Prof. dr Tomislav Kostić Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija; Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • Assist. dr Sonja Dakić Klinika za kardiologiju, Univerzitetski klinički centar Niš, Niš 18000, Srbija; Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • Jelena Cvetković Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
  • Jovana Šarić Medicinski fakultet, Univerzitet u Nišu, Niš 18000, Srbija
DOI: https://doi.org/10.5937/afmnai41-49993
Ključne reči: infarkt miokarda, mlađi pacijenti, faktori rizika

Sažetak


Uvod: Cilj istraživanja bio je da uporedimo pacijente do 45 godina starosti sa akutnim infarktom mioarda (AIM) u razmaku od 10 godina, kako bi pokazali da li se učestalost AIM kod mlađih povećala i da li postoje promene u faktorima rizika.

Meterijal i metode: Retrospektivnim ispitivanjem obuhvaćeni su pacijenti hospitalizovani na Klinici za kardiologiju, UKC Niš, sa dijagnozom AIM tokom 2023. i 2013. godine. Izdvojeni su pacijenti do 45 godina starosti iz obe kalendarske godine i potom je upoređena učestalost infarkta, faktori rizika za koronarnu bolest, način prezentovanja i rasprostranjenost koronarne bolesti u obe grupe.

Rezultati: Tokom perioda od 10 godina, ukupan broj pacijenata koji se godišnje hospitalizuju sa AIM je povećan (985 vs 1691). Značajno je povećan udeo mlađih pacijenata, od 18 (1,7%) 2013. na 57 (3,4%) 2023, p=0.008. Najmlađi pacijent sa AIM 2013. godine imao je 31 godinu, a 2023. – 25 godina. Značajno više pacijenata je imalo dislipidemiju (89,8% vs 47,1%) i pozitivnu porodičnu anamnezu (87,8% vs 47,1%) u grupi iz 2023. godine. Većina pacijenata u obe grupe prezentovala sa kao STEMI i većina je imala jednosudovnu bolest. Tokom 2023. povećan je broj mlađih pacijenata sa trosudovnom bolešću (5,3% vs 0%).

Zaključak: Udeo pacijenata do 45 godina starosti među pacijentima sa AIM u našoj sredini se povećao tokom desetogodišnjeg perioda, a minimalni broj godina kada se bolest javlja i prosečna starost ove grupe pacijenata se smanjila.

Reference

1. Tsao CW, Aday AW, Almarzooq ZI, et all. Heart Disease and Stroke Statistics - 2023 Update: A Report From the American Heart Association. Circ 2023; 147(8): e93-e621. Available from: https://doi.org/10.1161/CIR.0000000000001123
2. Reynolds K, Go AS, Leong TK, et al. Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN). Am J Med 2017; 130(3): 317–27.
3. Krumholz HM, Normand S-LT, Wang Y. Twenty-Year Trends in Outcomes for Older Adults With Acute Myocardial Infarction in the United States. JAMA Netw Open 2019; 2(3): e191938-e. Available from: https://pubmed.ncbi.nlm.nih.gov/30874787/
4. Wu WY, Berman AN, Biery D, et al. Recent Trends in Acute Myocardial Infarction Among the Young. Curr Opin Cardiol 2020; 35(5): 524–530.
5. Bauer D, Neuberg M, Nováčková M, et al. Pre-hospital delay, clinical characteristics, angiographic findings, and in-hospital mortality in young and middle-aged adults with acute coronary syndrome: a single-centre registry analysis. Eur Heart J Suppl 2023; 25 (Supplement E): E33–E39.
6. Matsis K, Holley A, Al-Sinan A, et al. Differing Clinical Characteristics Between Young and Older Patients Presenting with Myocardial Infarction. Heart Lung Circ 2017; 26: 566–571.
7. Liu Q, Shi RJ, Zhang YM, et al. Risk factors, clinical features, and outcomes of premature acute myocardial infarction. Front Cardiovasc Med 2022; 9: 1012095. Available from: https://www.frontiersin.org/articles/10.3389/fcvm.2022.1012095/full
8. Yanase T, Sakakura K, Taniguchi Y, et al. Comparison of Clinical Characteristics of Acute Myocardial Infarction Between Young (< 55 Years) and Older (55 to < 70 Years) Patients. Int Heart J 2021; 62(1): 33-41.
9. Sood A, Singh A, Gadkari C. Myocardial Infarction in Young Individuals: A Review Article. Cureus 2023; 15(4): e37102. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166330/
10. Klein LW and Nathan S. Coronary Artery Disease in Young Adults. JACC 2003; 41(4): 529–31.
11. Vaccarino V, Sullivan S, Hammadah M, et all. Mental Stress–Induced-Myocardial Ischemia in Young Patients With Recent Myocardial Infarction. Circ 2018; 137(8): 794-805.
12. Kuehnemund L, Koeppe J, Feld J, et al. Gender differences in acute myocardial infarction - A nationwide German real-life analysis from 2014 to 2017. Clin Cardiol 2021; 44(7): 890-898.
13. Zhang D, Zuo H, Yang H, et al. Comparison of clinical profiles and associated factors for acute myocardial infarction among young and very young patients with coronary artery disease. Coron Artery Dis 2022; 33(8): 655-660.
14. Palmer J, Lloyd A, Steele L, et al. Differential Risk of ST Segment Elevation Myocardial Infarction in Male and Female Smokers. J Am Coll Cardiol 2019; 73(25): 3259–66.
15. Biery DW, Berman AN, Singh A, et al. Association of smoking cessation and survival among young adults with myocardial infarction in the Partners YOUNG-MI registry. JAMA Netw Open 2020; 3: e209649. Available from: https://pubmed.ncbi.nlm.nih.gov/32639567/
16. Messner B and Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol 2014; 34: 509–515.
17. Csordas A and Bernhard D. The biology behind the atherothrombotic effects of cigarette smoke. Nat Rev Cardiol 2013; 10: 219–230.
18. Weiner P, Waizman J, Weiner M, et al. Smoking and first acute myocardial infarction: age, mortality and smoking cessation rate. Isr Med Assoc J 2000; 2: 446–449.
19. SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J 2021; 42: 2439-2454.
20. SCORE2-OP working group and ESC Cardiovascular risk collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. Eur Heart J 2021; 42: 2455-2467.
21. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021; 42: 3227-3337.
Objavljeno
2025/11/19
Broj časopisa
Vol. 41 Br. 4 (2024): Acta facultatis medicae Naissensis
Rubrika
Originalni rad / Original article