Study of coronary artery disease in patients under 45 years of age
Keywords:
coronary artery diseases, acute myocardial infarction, young adultsAbstract
Introduction and objectives: Coronary artery disease is the main cause of death in the developed world, also affecting young people. This investigation aims at determining the characteristics of such an illness in people under 45 years of age. Method: A retrospective study was carried out during a two year period in the provincial hospitals of Villa Clara province. Results: 84,0 percent of the patients were male, and 68,0 percent were between the ages of 40 and 45. The infarction of the inferior wall represented 56.0 percent, 31 patients (62,0 %) presented a positive ergometry, 44 patients (88,0 %) had a normal ejection fraction, 34 patients (68,0 %) suffered from alterations of the regional motility, 92,0 percent had normal ventricular diameters and 76,0 percent showed a normal pattern of relaxation of the left ventricle (p = 0,000). Only 7 patients (14,0 %) had normal arteries. In the 43 remaining patients, 46,5 % presented type C lesions, 60,5 percent had the right coronary as the one responsible for the infarction, 60,5 percent had only one vessel affected, and 88.4 percent had stenosis obstructing more than half the diameter of the artery. Conclusions: In the investigation there was a prevalence of male individuals, the group between 40 and 45 years of age, an inferior localization, alterations of the ergonometric test, a normal LVEF, alterations of the regional contractibility, normal ventricular diameter and relaxation pattern, and a positive coronariography with a predominant damage of one vessel, left coronary and type C lesions.
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1. Moreno-Martínez FL, Aladro Miranda IF, Ibargollín Hernández R, Vega Fleites LF, Fleites Cárdenas HA, González Chinea R, et al. Efecto del Policosanol en la reestenosis del stent coronario. Rev Esp Cardiol [Resumen] 2008;61(Supl 3):14. Disponible en: http://www.revespcardiol.org/watermark/ctl_servlet?_f=10&pident_articulo=13137240&pident_usuario=0&pident_revista=25&fichero=25v61nSupl.3a13137240pdf001.pdf&ty=165&accion=L&origen=cardio&web=www.revespcardiol.org&lan=es
2. Infomed [sitio web en Internet]. Villa Clara: Infomed Villa Clara; ©1999-2007 [actualizado 11 Sep 2009; citado 11 sep 2009]. Disponible en: http://bvs.sld.cu/cgi-bin/wxis/anuario/?IsisScript=anuario/iah.xis&base=anuario&lang=e
3. Fornes P, Lecomte D. Sudden out-of-hospital coronary death in patients with no previous cardiac history. An analysis of 221 patients studied at autopsy. J Forensic Sci. 2002;38:1084-91.
4. Burns JC, Shike H, Gordon JB, Malhotra A, Ahoenwetter M. Sequelae of Kawasaki disease in adolescents and young people. J Am Coll Cardiol. 2003;28: 253-7.
5. Corrado D, Thiene G, Pennelli N. Sudden death as the first manifestation of coronary artery disease in young people. Eur Heart J. 2000;9:139-44.
6. Chaitman R. B, editor. Pruebas de esfuerzo. Tratado de Cardiología vol.2. 6ta. ed. México D.F: McGraw-Hill-Interamericana; 2003. p. 174-80.
7. Shahin GM, Bosker H.A, Knaepen PJ, Morshuis WJ, Lindeboom JE. Organized thrombus in the ascending aorta originating from the ostium of the right coronary artery. Cardiovascr Surg. 2002 Feb;10(1):62-4.
8. English JP, Willius FA, Berksan J. Tobacco and coronary disease. JAMA. 2005;115:1327-9.
9. Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking. A second report on the mortality of British doctors. BMJ. 2004;2:1071-81.
10. Gaziano JM, Buring JE, Breslow JL. Moderate alcohol in take, increased levels of high- density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med. 2003;329:1829-34.
11. Hendrinks HF, Van der Gaag MS. Alcohol, coagulation and fibrinolysis. Novartis Found Symp. 2005;216:111-20.
12. Criqui MH, Cowan LD, Tyroler HA. Lipoproteins as mediators for the effects of alcohol consumption and cigarette smoking on cardiovascular mortality: Results from the lipid research clinics follow-up study. Am J Epidemiol. 2007;126:629-37.
13. Isser HS, Puri VK, Narain VS, Saran RK, Dwivedi SK , Singh S. Lipoprotein (a) and lipid levels in young patients with myocardial infarction and their first-degree relatives. Indian Heart J 2001;53:463-6.
14. Cáceres Lóriga FM. Cardiopatía isquémica en el adulto joven. Rev Cub Med Int Emerg. 2004;3(2):1-4.
15. Adams J, Abendschein D, Jaffe A. Biochemical markers of myocardial injury: Is MB creatine kinase the choice for the 1990s? Circulation 2003;88: 750.
16. Goldstein JA, Demetriou D, Grines CL. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med. 2005;343:915-22.
17. Mieres JH, Shaw LJ, Arai A, Budoff Mj, Flamm SD, Marwick TH, et al. Role of non invasive testing in the clinical evaluation of women with suspected coronary artery disease. Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology and Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation. 2005 feb 8;11(5):682-96.
18. Lansky AJ, Chair J S, Hochman PA, Ward MA, Gary S. M, Fabunmi R, et al. Percutaneous coronary intervention and adjunctive pharmacotherapy in women. A statement for Healthcare Professionals from the American Heart Association. Circulation 2005;111: 940-53.
19. Canto JG, Allison JJ, Kiefe CI, Fincher C, Farmer R, Sekar P, et al. Relation of race and sex to the use of reperfusion therapy in Medicare beneficiaries with acute myocardial infarction. N Engl J Med 2000;342(15):1094-100.
20. Sitges M, Roqué M, Solanes N, Rigor M, Heras M, Roig E, et al. El estradiol potencia la vasodilatación dependiente del endotelio a través del óxido nítrico. Rev Esp Cardiol 2001;54(8):990-6.
21. Bittner V. Perspectives on dyslipidemia and coronary heart disease in women. J Am Coll Cardiol 2005;46:1628-35.
22. Davis LL, Evans JJ, Strickland JD, Shaw LK, Wagner GS. Delays in thrombolytic therapy for acute myocardial infarction: association with mode of transportation to the hospital, age, sex, and race. Am J Crit Care 2001;10(1):35-42.
23. Moreno-Martínez FL, Escobar Blanco A, Díaz López F, Alegret Rodríguez M, López-Bernal OJ, Aladro Miranda I, et al. Factores de riesgo coronario y riesgo cardiovascular en personas adultas de un área de salud de Rancho Veloz (Cuba). Clin Invest Arterioscl. 2008;20(4):151-61.
24. Sheifer SE, Rathore SS, Gersh BJ, Weinfurt KP, Oetgen WJ, Breall JA, et al. Time to presentation with acute myocardial infarction in the elderly: associations with race, sex, and socioeconomic characteristics. Circulation 2000;102(14):1651-6.
25. Rathore SS, Berger AK, Weinfurt KP, Feinleib M, Oetgen WJ, Gersh BJ, et al. Race, sex, poverty, and the medical treatment of acute myocardial infarction in the elderly. Circulation 2000;102(6):642-8.
26. Marrugat J, Solanas P, D’Agostino R, Sullivan R, Ordovas J, Cordón F, et al. Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada. Rev Esp Cardiol 2003;56:253-61.
27. de Velazco JA, Llargués E, Fitó R, Sala J, del Río A, de los Arcos, et al. Prevalencia de los factores de riesgo y tratamiento farmacológico al alta hospitalaria en el paciente coronario. Resultados de un registro multicéntrico nacional (Programa 3C). Rev Esp Cardiol 2001;54(2):159-68.
28. Heras M. Cardiopatía isquémica en la mujer: presentación clínica, pruebas diagnósticas y tratamiento de los síndromes coronarios agudos. Rev Esp Cardiol 2006;59(4):371-81.
29. De la Cruz R, Palacios JM, Muñiz A, Reyes S, Jáuregui O, Ogaz E. Revascularización percutánea en cardiopatía isquémica en pacientes con disfunción ventricular sistólica izquierda. Rev Mex Cardiol. 2004;15(3):95-9.
30. García Barsottia MA, Corbalán Herrerosa R, Nazzal Nazala C, Marchant Díaza E, Castro Gálveza P, Pérez Pérez O, et al. Valor pronóstico de marcadores no invasivos de reperfusión coronaria frente a flujo TIMI 3 en pacientes tratados con angioplastia primaria. Rev Esp Cardiol. 2004;57(6):524-30.
31. Elhendy A, O'Leary EL, Xie F, McGrain AC, Anderson JR, Porter TR. Comparative accuracy of real-time myocardial contrast perfusion imaging and wall motion analysis during dobutamine stress echocardiography for the diagnosis of coronary artery disease. J Am Coll Cardiol. 2004;44(11):2185-91.
32. Libby P, Theroux P. Pathophysiology of coronary artery disease. Circulation 2005;111:3481-8.
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