Risk factors and in-hospital outcome of acute ST segment elevation myocardial infarction in young Bangladeshi adults

BMC Cardiovascular Disorders

Research Article

Makhan Lal Paul¹  Kamrun N. Chowdhury²  Sheikh Mohammed Shariful Islam³  Mohammad Azizul Karim⁴  Abdullah Al Shafi Majumder⁴  Khandaker Qamrul Islam⁴  Muhammad Badrul Alam⁵  Mohammad Shafiqul Islam⁶ 

[1] Central Medical College, Comilla, Bangladesh;Department of Epidemiology, National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh;International Center for Diarrhoeal Disease Research, Bangladesh, Center for Control of Chronic Diseases, Dhaka, Bangladesh;Center for International Health, University of Munich, Munich, Germany;Cardiovascular Division, The George Institute for Global Health, Sydney, Australia;National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh;Rangpur Medical College, Rangpur, Bangladesh;Trishal Health Complex, Mymensingh, Bangladesh;

关键词: Homocysteine;    Acute Myocardial Infarction;    Young Group;    Cardiogenic Shock;    Preventable Risk Factor;   

DOI  :  10.1186/s12872-015-0069-2

 received in 2014-12-01, accepted in 2015-07-08,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSouth Asians have a higher overall incidence rate and younger age of onset for acute myocardial infarction (AMI) compared to Western populations. However, limited information is available on the association of preventable risk factors and outcomes of AMI among young individuals in Bangladesh. The aim of this study was to determine the risk factors and in-hospital outcome of AMI among young (age ≤40 years) adults in Bangladesh.MethodsWe conducted a prospective observational study among consecutive 50 patients aged ≤40 years and 50 patients aged >40 years with acute ST Segment Elevation Myocardial Infarction (STEMI) and followed-up in-hospital at the National Institute of Cardiovascular Diseases (NICVD). Clinical characteristics, biochemical findings, diet, echocardiography and in-hospital outcomes were compared between the two groups. Multivariate logistic regression was performed to assess the association between risk factors and in-hospital outcome in young patients adjusting for other confounding variables.ResultsThe mean age of the young and older patient groups was 36.5 ± 4.6 years and 57.0 ± 9.1 years respectively. Male sex (OR 3.4, 95 % CI 1.2 − 9.75), smoking (OR 2.4, 95 % CI 1.04 − 5,62), family history of MI (OR 2.4, 95 % CI 1.11 − 5,54), homocysteine (OR 1.2, 95 % CI 1.08 − 1.36), eating rice ≥2 times daily (OR 3.5, 95 % CI 1.15 − 10.6) and eating beef (OR 4.5, 95 % CI 1.83 − 11.3) were significantly associated with the risk of AMI in the young group compared to older group. In multivariate analysis, older patients had significantly greater chance of developing heart failure (OR 7.5, 95 % CI 1.51 to 37.31), re-infarction (OR 7.0, 95 % CI 1.08 − 45.72), arrhythmia (OR 15.3, 95 % CI 2.69 − 87.77) and cardiogenic shock (OR 69.0, 95 % CI 5.81 − 85.52) than the younger group.ConclusionYounger AMI patients have a different risk profile and better in-hospital outcomes compared to the older patients. Control of preventable risk factors such as smoking, unhealthy diet, obesity and dyslipidemia should be reinforced at an early age in Bangladesh.

【 授权许可】

Unknown   
© Karim et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.