A Clinical Study of Acute St Elevation Myocardial Infarction in Young Indian Adults

BACK GROUND Coronary artery disease occurs 5-10 years earlier than the Europeans in Asian Indians. Up to 12 % of the cardiovascular diseases in India occurs in the young adults which contribute to about 1/4th of the total CVD related mortality which shows the need for proper studying of this group and urgent action on preventable factors. AIM OF THE STUDY 1. To study the clinical profile of young adults presenting with acute ST elevating myocardial infarction aged 35 years and below 2. To Study the conventional risk factor profile in these patients. STUDY DESIGN Prospective observational study. STUDY DURATION The study was done during the period of January 2014 to January 2016. MATERIALS and METHODS This study was done in the departments of Cardiology and Critical care, Apollo health city, hyderabad. Study group consisted of 71 patients admitted to the emergency room and ICU s with acute STEMI all of whom were aged less than or equal to 35 years of age and diagnosed by ECG criteria. History, anthropometric data, blood investigations, 2Decho, coronary angiogram etc were done accordingly and the data was analysed subsequently. RESULTS In the study population 92.95 % were males.53 (74.64 %) of the patients were among the 31 35 year age group followed by 26-30 yr age group 13 (18.31 %) and least no. Of patients in 21 25 yr age group 5 (7.04 %). The mean age of onset was 32.66 yrs. Up to 80.4 % of the patients presented with typical retrosternal, squeezing type of chest pain.77.46 % presented within 12 hr of window period whereas 70.42 % presented within 6 hr of WP. Delay in referral to the tertiary centre was a factor in 50 % of the patients who presented beyond 12 hr. Mean BMI of the study group is 23.83 (+/-3.46). Risk factor percentage were smoking (69 %) followed by low HDL (60.5 %), overweight/obesity (57.7 %), high TG (47.9 %), alcohol (45 %), high LDL (35.2 %). Anterior ST elevation MI was in (66.2 %). Inferior STEMI (28.2 %) followed by high lateral STEMI (2.8 %), anterior + inferior STEMI (2.8 %). Angiographic findings were SVD in 65.4 5, DVD in 15.4 %, TVD in 5.8 % and normal in 13.4 %. Complications were left ventricular failure (14 %) followed by Brady arrhythmias (5.6 %). Death occurred in 2 patients (2.8 %). CONCLUSIONS This study suggests that young adults with Acute STEMI were predominantly males. Most common presenting complaint was typical angina chest pain. Most common factor for delayed window period and not getting thrombolysis was Delay in referral form local practitioners. This shows the need for proper training of local practitioners. Smoking was the most common risk factor among the study group followed by abdominal obesity and Hypertension. Family history was much less common. Majority of the patients presented with Anterior STEMI. Most of them presented with Normal hemodynamic i. e. , killips class I. Single vessel Disease was the commonest finding on Angiogram. Most common complication among the study group was left ventricular failure.