Predictors of lethality in young patients with acute myocardial infarction

Abstract

The profile and combination of risk factors vary among patients with acute myocardial infarction (AMI) in different age groups. Their screening may help to improve prognosis in a young population. Aim. To identify the predictors of lethality in young patients with AMI. Material and methods. Using the data from the acute myocardial infarction registry, two groups of patients under 45 years were formed: deceased (group 1) and survivors (group 2) after AMI. Results. Patients in group 1 were younger than in group 2. Atypical pain syndrome or syncope were documented in 21,1% of the patients in group 1. For patients who died in different hospitals (n=13), duration of period between pain onset and ambulance call and between ambulance call and arrival were shorter in group 1. Only 38,5% of them were delivered to specialized units. The fraction of patients admitted to cardiological departments among survivors was 93,3% (p<0.001). Some patients of both groups reported changes in the state of health before AMI. In group 1, they often were nonspecific (weakness, blood pressure changes etc.). The risk of death for smokers was twice that for non-smokers. Hospitalization in a specialized hospital as well as timely seeking medical aid in case of unstable angina increased the chance of survival. Conclusions. An early appeal for help is very important for young patients with new/worsening symptoms threatening rapid onset of death. As far as patients having no histories of coronary disorders are concerned, efforts of the medical community should be focused on extensive screening of risk factors and their effective correction with the development of stratification scales for the early evaluation of the likelihood of adverse outcomes.