Coronary artery disease with premature manifestation in young patients

Česká verzia

Authors: O. Toman; M. Poloczek; J. Pařenica; P. Kala; R. Jenyšová; L. Dostálová; J. Špinar
Authors place of work: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
Published in the journal: Vnitř Lék 2008; 54(9): 810-816
Category: Original Contributions

Summary

Introduction:
Coronary artery disease (CAD) affects in lower percentage even younger individuals. This paper describes group of young patients aged 40 years or less with premature manifestation of CAD, including analysis of risk factors, severity of coronary arteries affection, management and follow-up lasting up to 7 years.

Patients and methods:
There were 98 patients included retrospectively, in whom macroscopic affection of coronary arteries was diagnosed by coronary angiography within the years 2000–2007. 68 of the patients were indicated to coronary angiography urgently due to acute coronary syndrome (ACS), 44 of them due to acute myocardial infarction with ST elevations. The patients were called for further co-operation and 45 of them (45.9%) were re-examined completely and they will be observed prospectively.

The results show overall good short-term prognosis of these patients and confirm importance of early invasive management and revascularisation. One-year mortality of the patients with ACS was 1.9%. 80% out of 45 completely re-examined patients have ejection fraction of left ventricle better than 50% and 84% of them is without any anginal symptoms. However, our results show inadequate secondary prevention in these patients. 15 patients (33%) still smoke, 20 (44%) is over-weighted. Only 22 patients (49%) had LDL-cholesterol level bellow 2.5 mmol/ l and even only 15 patients (33%) had blood pressure bellow 130/80 mm Hg.

Conclusions:
Management of these basic risk factors should improve even the long-term prognosis of our patients.

Key words:
coronary artery disease – premature manifestation – accelerated atherosclerosis – myocardial infarction – young adults – risk factors

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