Key result
Young patients (<50 years) with acute coronary syndrome had a significantly higher prevalence of cardio-pulmonary arrest on arrival compared to elderly patients (24.3% vs. 8.6%, p=0.003).
Why the study?
ACS in young patients carries devastating effects on their active lifestyle, yet guidelines regarding prevention in this population are lacking.
What are the epidemiological features and clinical presentations of acute coronary syndrome in young patients compared to elderly patients?
Cohort (n=361)
No
What are the epidemiological features and clinical presentations of acute coronary syndrome in young patients compared to elderly patients?
Absolute Event Rate: 24.3% vs 8.6%
p-value: p=0.003
Young patients with acute coronary syndrome exhibit distinct modifiable risk factors, including high rates of smoking, overweight, and low EPA/AA ratios, and present with more severe clinical conditions such as cardiac arrest compared to older patients.
Registry data on young ACS patients highlight prevention gaps; leaves open age-specific guidelines pending prospective validation.
Objective Although acute coronary syndrome (ACS) is an uncommon entity in young patients, it constitutes an important problem due to the devastating effects of the disease on the more active lifestyle of young patients. At present, there are no guidelines regarding the prevention of ACS in young patients. Methods We performed a retrospective study of ACS patients between 2014 and 2017. Epidemiological data, clinical findings, and short-term outcomes were evaluated between young ACS patients (≤50 years old) and elderly ACS patients (>50 years old). Results Of a total of 361 consecutive ACS patients, 37 were young ACS patients (10.2%). Compared with elderly ACS patients, young ACS patients showed a higher prevalence of males (94.6% vs. 73.8%, p<0.001), current smoking (70.3% vs. 29.9%; p<0.001), and overweight persons (67.6% vs. 27.8%, p<0.001). The eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio was significantly lower in young ACS patients than in elderly ACS patients [0.17 (0.12-0.25) vs. 0.25 (0.18-0.37), p=0.002]. The prevalence of cardio-pulmonary arrest and percutaneous cardiopulmonary support use was higher in young ACS patients than in elderly ACS patients (24.3% vs. 8.6%, p=0.003, 16.2% vs. 3.1%, p<0.001). Conclusion The features were markedly different between young ACS patients and elderly ACS patients. In young ACS patients, smoking, being overweight, and a low EPA/AA ratio were distinctive risk factors, and more serious clinical presentations were observed at the onset of ACS than in older patients.
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Sawada et al. (2020) conducted a cohort in Acute Coronary Syndrome (n=361). Young age (<50 years) vs. Elderly age (≥50 years) was evaluated on Cardio-pulmonary arrest on arrival (p=0.003). Young patients (<50 years) with acute coronary syndrome had a significantly higher prevalence of cardio-pulmonary arrest on arrival compared to elderly patients (24.3% vs. 8.6%, p=0.003).
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