Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients

Jae Yeong Cho, Myung Ho Jeong, Youngkeun Ahn, Shung Chull Chae, In Hwan Seong, Young Jo Kim, Junghan Yoon, Jay Young Rhew, Jei Keon Chae, In Ho Chae, Nae Hee Lee, Jin Yong Hwang, Myeong Chan Cho, Kee Sik Kim, Chong Jin Kim, Wook Sung Chung, Seung-Woon Rha, Yang Soo Jang, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Objectives: Acute myocardial infarction (AMI) occurring in patients at a young age (40 years or younger) is an uncommon condition and is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of young-aged Korean AMI patients (age of 40 years or younger) and other AMI patients, who were registered in the Korea Acute Myocardial Infarction Registry (KAMIR) for one year. Subjects and Methods: In 2006, 8,565 patients (mean age 64.4±12.7 years; 5,591 males) were registered in the KAMIR. The patients were divided into two groups: Group I (younger patients ≤40 years; n=261; mean age 35.9±4.5 years; 245 males) and Group II (older patients >40 years; n=8,304, mean age 65.4±11.8 years; 5,330 males). The clinical and angiographic characteristics and major adverse cardiac events (MACE) were compared for the two groups of patients. Results: The baseline clinical characteristics of gender, age, risk factors (hypertension, smoking, diabetes, familial history) and body weight were different between the two groups (p<0.001). The baseline echocardiographic and laboratory findings of the initial ejection fraction, and the glomerular filtration rate, level of creatine kinase (CK), level of CK-MB isoenzyme, total cholesterol level, triglyceride level, and N-terminal prohormone brain natriuretic peptide (NT-proBNP) level were different between the two groups (p≤0.001). According to the use of multiple logistic regression analysis, use of thrombolysis [p=0.009, adjusted hazard ratio (aHR)=9.140, 95% confidence interval (CI): 1.727-48.383], a high blood glucose level (p=0.029, aHR=1.008, 95% CI: 1.001-1.016), a low body mass index (<25 kg/m2, p=0.031, aHR=6.236, 95% CI: 1.183-32.857), and a high CK-MB level and high Thrombolysis in Myocardial Infarction (TIMI) risk score were independent predictors of MACE at 1 year after an AMI in young age patients. Early clinical outcomes were better in Group I than in Group II patients, but one-, six- and twelve-month MACE were not different between the two groups. Conclusion: The independent predictors of MACE at 1 year in young age AMI patients were the use of thrombolysis, a high blood glucose level, a low body mass index, a high CK-MB level and a high TIMI risk score. Patients that have had an acute myocardial infarction at a young age have a better early clinical outcome, but the long-term clinical outcomes were not different compared with older patients, and thus long-term intensive medical therapy will be required, even in young AMI patients.

Original languageEnglish
Pages (from-to)161-169
Number of pages9
JournalKorean Circulation Journal
Volume38
Issue number3
Publication statusPublished - 2008 Dec 1
Externally publishedYes

Fingerprint

Myocardial Infarction
MB Form Creatine Kinase
Confidence Intervals
Korea
Registries
Blood Glucose
Body Mass Index
Brain Natriuretic Peptide
Age Factors
Creatine Kinase
Glomerular Filtration Rate
Isoenzymes
Triglycerides
Logistic Models
Smoking
History
Cholesterol
Body Weight
Regression Analysis
Hypertension

Keywords

  • Age of onset
  • Myocardial infarction
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Cho, J. Y., Jeong, M. H., Ahn, Y., Chae, S. C., Seong, I. H., Kim, Y. J., ... Park, S. J. (2008). Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients. Korean Circulation Journal, 38(3), 161-169.

Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients. / Cho, Jae Yeong; Jeong, Myung Ho; Ahn, Youngkeun; Chae, Shung Chull; Seong, In Hwan; Kim, Young Jo; Yoon, Junghan; Rhew, Jay Young; Chae, Jei Keon; Chae, In Ho; Lee, Nae Hee; Hwang, Jin Yong; Cho, Myeong Chan; Kim, Kee Sik; Kim, Chong Jin; Chung, Wook Sung; Rha, Seung-Woon; Jang, Yang Soo; Seung, Ki Bae; Park, Seung Jung.

In: Korean Circulation Journal, Vol. 38, No. 3, 01.12.2008, p. 161-169.

Research output: Contribution to journalArticle

Cho, JY, Jeong, MH, Ahn, Y, Chae, SC, Seong, IH, Kim, YJ, Yoon, J, Rhew, JY, Chae, JK, Chae, IH, Lee, NH, Hwang, JY, Cho, MC, Kim, KS, Kim, CJ, Chung, WS, Rha, S-W, Jang, YS, Seung, KB & Park, SJ 2008, 'Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients', Korean Circulation Journal, vol. 38, no. 3, pp. 161-169.
Cho, Jae Yeong ; Jeong, Myung Ho ; Ahn, Youngkeun ; Chae, Shung Chull ; Seong, In Hwan ; Kim, Young Jo ; Yoon, Junghan ; Rhew, Jay Young ; Chae, Jei Keon ; Chae, In Ho ; Lee, Nae Hee ; Hwang, Jin Yong ; Cho, Myeong Chan ; Kim, Kee Sik ; Kim, Chong Jin ; Chung, Wook Sung ; Rha, Seung-Woon ; Jang, Yang Soo ; Seung, Ki Bae ; Park, Seung Jung. / Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients. In: Korean Circulation Journal. 2008 ; Vol. 38, No. 3. pp. 161-169.
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author = "Cho, {Jae Yeong} and Jeong, {Myung Ho} and Youngkeun Ahn and Chae, {Shung Chull} and Seong, {In Hwan} and Kim, {Young Jo} and Junghan Yoon and Rhew, {Jay Young} and Chae, {Jei Keon} and Chae, {In Ho} and Lee, {Nae Hee} and Hwang, {Jin Yong} and Cho, {Myeong Chan} and Kim, {Kee Sik} and Kim, {Chong Jin} and Chung, {Wook Sung} and Seung-Woon Rha and Jang, {Yang Soo} and Seung, {Ki Bae} and Park, {Seung Jung}",
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TY - JOUR

T1 - Predictive factors of major adverse cardiac events and clinical outcomes of acute myocardial infarction in young Korean patients

AU - Cho, Jae Yeong

AU - Jeong, Myung Ho

AU - Ahn, Youngkeun

AU - Chae, Shung Chull

AU - Seong, In Hwan

AU - Kim, Young Jo

AU - Yoon, Junghan

AU - Rhew, Jay Young

AU - Chae, Jei Keon

AU - Chae, In Ho

AU - Lee, Nae Hee

AU - Hwang, Jin Yong

AU - Cho, Myeong Chan

AU - Kim, Kee Sik

AU - Kim, Chong Jin

AU - Chung, Wook Sung

AU - Rha, Seung-Woon

AU - Jang, Yang Soo

AU - Seung, Ki Bae

AU - Park, Seung Jung

PY - 2008/12/1

Y1 - 2008/12/1

N2 - Background and Objectives: Acute myocardial infarction (AMI) occurring in patients at a young age (40 years or younger) is an uncommon condition and is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of young-aged Korean AMI patients (age of 40 years or younger) and other AMI patients, who were registered in the Korea Acute Myocardial Infarction Registry (KAMIR) for one year. Subjects and Methods: In 2006, 8,565 patients (mean age 64.4±12.7 years; 5,591 males) were registered in the KAMIR. The patients were divided into two groups: Group I (younger patients ≤40 years; n=261; mean age 35.9±4.5 years; 245 males) and Group II (older patients >40 years; n=8,304, mean age 65.4±11.8 years; 5,330 males). The clinical and angiographic characteristics and major adverse cardiac events (MACE) were compared for the two groups of patients. Results: The baseline clinical characteristics of gender, age, risk factors (hypertension, smoking, diabetes, familial history) and body weight were different between the two groups (p<0.001). The baseline echocardiographic and laboratory findings of the initial ejection fraction, and the glomerular filtration rate, level of creatine kinase (CK), level of CK-MB isoenzyme, total cholesterol level, triglyceride level, and N-terminal prohormone brain natriuretic peptide (NT-proBNP) level were different between the two groups (p≤0.001). According to the use of multiple logistic regression analysis, use of thrombolysis [p=0.009, adjusted hazard ratio (aHR)=9.140, 95% confidence interval (CI): 1.727-48.383], a high blood glucose level (p=0.029, aHR=1.008, 95% CI: 1.001-1.016), a low body mass index (<25 kg/m2, p=0.031, aHR=6.236, 95% CI: 1.183-32.857), and a high CK-MB level and high Thrombolysis in Myocardial Infarction (TIMI) risk score were independent predictors of MACE at 1 year after an AMI in young age patients. Early clinical outcomes were better in Group I than in Group II patients, but one-, six- and twelve-month MACE were not different between the two groups. Conclusion: The independent predictors of MACE at 1 year in young age AMI patients were the use of thrombolysis, a high blood glucose level, a low body mass index, a high CK-MB level and a high TIMI risk score. Patients that have had an acute myocardial infarction at a young age have a better early clinical outcome, but the long-term clinical outcomes were not different compared with older patients, and thus long-term intensive medical therapy will be required, even in young AMI patients.

AB - Background and Objectives: Acute myocardial infarction (AMI) occurring in patients at a young age (40 years or younger) is an uncommon condition and is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of young-aged Korean AMI patients (age of 40 years or younger) and other AMI patients, who were registered in the Korea Acute Myocardial Infarction Registry (KAMIR) for one year. Subjects and Methods: In 2006, 8,565 patients (mean age 64.4±12.7 years; 5,591 males) were registered in the KAMIR. The patients were divided into two groups: Group I (younger patients ≤40 years; n=261; mean age 35.9±4.5 years; 245 males) and Group II (older patients >40 years; n=8,304, mean age 65.4±11.8 years; 5,330 males). The clinical and angiographic characteristics and major adverse cardiac events (MACE) were compared for the two groups of patients. Results: The baseline clinical characteristics of gender, age, risk factors (hypertension, smoking, diabetes, familial history) and body weight were different between the two groups (p<0.001). The baseline echocardiographic and laboratory findings of the initial ejection fraction, and the glomerular filtration rate, level of creatine kinase (CK), level of CK-MB isoenzyme, total cholesterol level, triglyceride level, and N-terminal prohormone brain natriuretic peptide (NT-proBNP) level were different between the two groups (p≤0.001). According to the use of multiple logistic regression analysis, use of thrombolysis [p=0.009, adjusted hazard ratio (aHR)=9.140, 95% confidence interval (CI): 1.727-48.383], a high blood glucose level (p=0.029, aHR=1.008, 95% CI: 1.001-1.016), a low body mass index (<25 kg/m2, p=0.031, aHR=6.236, 95% CI: 1.183-32.857), and a high CK-MB level and high Thrombolysis in Myocardial Infarction (TIMI) risk score were independent predictors of MACE at 1 year after an AMI in young age patients. Early clinical outcomes were better in Group I than in Group II patients, but one-, six- and twelve-month MACE were not different between the two groups. Conclusion: The independent predictors of MACE at 1 year in young age AMI patients were the use of thrombolysis, a high blood glucose level, a low body mass index, a high CK-MB level and a high TIMI risk score. Patients that have had an acute myocardial infarction at a young age have a better early clinical outcome, but the long-term clinical outcomes were not different compared with older patients, and thus long-term intensive medical therapy will be required, even in young AMI patients.

KW - Age of onset

KW - Myocardial infarction

KW - Prognosis

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