Acute coronary syndrome in patients younger than 30 years--aetiologies, baseline characteristics and long-term clinical outcome

Puricel, Serban; Lehner, Cedric; Oberhänsli, Markus; Rutz, Tobias; Togni, Mario; Stadelmann, Mathieu; Moschovitis, Aris; Meier, Bernhard; Wenaweser, Peter; Windecker, Stephan; Stauffer, Jean-Christophe; Cook, Stéphane (2013). Acute coronary syndrome in patients younger than 30 years--aetiologies, baseline characteristics and long-term clinical outcome. Swiss medical weekly, 143, w13816. EMH Schweizerischer Ärzteverlag 10.4414/smw.2013.13816

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BACKGROUND Coronary atherosclerosis begins early in life, but acute coronary syndromes in adults aged <30 years are exceptional. We aimed to investigate the rate of occurrence, clinical and angiographic characteristics, and long-term clinical outcome of acute coronary syndrome (ACS) in young patients who were referred to two Swiss hospitals. METHODS From 1994 to 2010, data on all patients with ACS aged <30 years were retrospectively retrieved from our database and the patients were contacted by phone or physician's visit. Baseline, lesion and procedural characteristics, and clinical outcome were compared between patients in whom an underlying atypical aetiology was found (non-ATS group; ATS: atherosclerosis) and patients in whom no such aetiology was detected (ATS group). The clinical endpoint was freedom from any major adverse cardiac event (MACE) during follow-up. RESULTS A total of 27 young patients with ACS aged <30 years were admitted during the study period. They accounted for 0.05% of all coronary angiograms performed. Mean patient age was 26.8 ± 3.5 years and 22 patients (81%) were men. Current smoking (81%) and dyslipidaemia (59%) were the most frequent risk factors. Typical chest pain (n = 23; 85%) and ST-segment elevation myocardial infarction (STEMI; n = 18 [67%]) were most often found. The ATS group consisted of 17 patients (63%) and the non-ATS group of 10 patients (37%). Hereditary thrombophilia was the most frequently encountered atypical aetiology (n = 4; 15%). At 5 years, mortality and MACE rate were 7% and 19%, respectively. CONCLUSION ACS in young patients is an uncommon condition with a variety of possible aetiologies and distinct risk factors. In-hospital and 5-year clinical outcome is satisfactory.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Oberhänsli, Markus; Rutz, Tobias; Stadelmann, Mathieu; Moschovitis, Aris; Meier, Bernhard; Wenaweser, Peter Martin; Windecker, Stephan and Cook, Stéphane

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Judith Liniger

Date Deposited:

19 Mar 2014 12:13

Last Modified:

05 Dec 2014 10:32

Publisher DOI:

10.4414/smw.2013.13816

PubMed ID:

23896944

BORIS DOI:

10.7892/boris.41662

URI:

https://boris.unibe.ch/id/eprint/41662

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