medigraphic.com
ISSN 1561-2937 (Print)

2021, Number 4

Next >>

Rev Cubana Cardiol Cir Cardiovasc 2021; 27 (4)

Percutaneous Coronary Intervention in young individuals with Acute Myocardial Infarction. 5-year experience at the Military Hospital: ''Dr. Carlos J. Finlay''

Tamayo SEA, Ravelo DR, Silva GML

Language: Spanish
References: 44
Page: 1-10
PDF size: 460.71 Kb.


ABSTRACT

Introduction: There are several mechanisms involved in the genesis of Myocardial Infarction in young individuals. This is currently a topic of interest and percutaneous coronary intervention is a vital tool in the treatment of these patients.
Objectives: To characterize young patients with Acute Myocardial Infarction undergoing percutaneous coronary intervention at Hospital Carlos J. Finlay between January 2014 and December 2019.
Method: A descriptive, cross-sectional study was carried out with 212 operated patients.
Results: Male sex (69,8%) with a mean age of 42 ± 3.8 years, Smoking (59,4%), arterial hypertension (53,8%), dyslipidemia (29,2%)and the anterior topography (42,4%), were the prevalent baseline characteristics. The most affected artery was the anterior descending artery (41,4%) in its proximal segment (65,6%). Salvage angioplasty was the most frequent intervention modality (41,0%) and the conventional stent was the most used (61,1%). 10,8% presented some complication, being bleeding at the puncture site the most frequent (52,1%), followed by the no-reflow phenomenon (26,0%). The anterior descending approach was a factor associated with the development of complications (p = 0, 01).
Conclusions: In young patients with acute myocardial infarction, taken to percutaneous coronary intervention, smoking and hypertension are the main baseline characteristics and the involvement of the proximal anterior descending artery is the most prevalent fact. The rescue approach was the most used with a low percentage of complications.


REFERENCES

  1. WHO. World Health Organization.http://www.who.int/cardiovascular_diseases/en/ (accessed 16 January 2012).

  2. Azin A, Farnaz S, Mehrnoosh T. Risk factors, Clinical manifestations and Outcome of Acute Myocardial Infarction in Young Patients; J CardiovascThorac Res. 2015; 2 (1): 29-34.

  3. Cardiovascular Disease Statistics. 2018. American Heart Association Press: [actualized Sept 8, 2018; cited March 9, 2018] available en: http://www.americanheart.org/presenter.jhtml?identifier=4478.

  4. Centers for Disease Control and Prevention: National Center for Health Statistics, National Vital Statistics and the United States Bureau of the Census. Health, United States.2019:31.

  5. Celik T, Iyisoy A. Premature coronary artery disease in young patients: an uncommon but growing entity. Int J Cardiol. 2015; 144:131-132.

  6. Klein L, Nathan S. Coronary artery disease in young adults.J Am CollCardiol. 2016; 41:529-531.

  7. Cengel A, Tanindi A. Acute Myocardial infarction in the young. J Postgrad Med. 2017; 55:305-13.

  8. Caimi G, Valenti A, Lo Presti R. Acute myocardial infarction in young adults: evaluation of the haemorheological pattern at the initial stage, after 3 and 12 months. AnnInst Super Sanità. 2017; 43(2): 139-143.

  9. Gulati R, Behfar A, Narula J, Kanwar A, Lerman A, Cooper L. Infartoagudo de miocárdico en individuos jóvenes. MayoClin Proc. 2020; 95(1):136-56.

  10. Gupta A in Youn, Wang Y, Spertus J, Geda M, Lorenze N, Nkonde C, et al.Trends in Acute Myocardial Infarction g patients and differences by sex and race.J Am CollCardiol. 2014, 64(4): 337–45.

  11. Borja I, Stefan J, Antunes M, Goudevenus J, Agewall S, BucciarelliC, et al. H ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. Circulation. 2017; 127(4):362-425.

  12. Steg G, James S, Atar D, Badano L, Blomstrom L, Borger M, et al. Guía de práctica clínica de la ESC para el manejo del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev.Esp.Cardiol. 2015; 66(1):53-62.

  13. Werf F, Bax J, Betriu A, Blomstrom C, Crea F, Falk V, et al. Guías de Práctica Clínica de la Sociedad Europea de Cardiología (ESC). Manejo del infarto agudo de miocardio en pacientes con elevación persistente del segmento ST. RevEspCardiol. 2018; 62(3): e1-e47.

  14. Borgia F, Goodman S, Le May M, Fernandez F.Early routine percutaneous coronary intervention after fibrinolisys vs. Standard therapy in ST segment elevation myocardial infarction: meta-analysis. EurHeart J. 2016; 31(17): 2156-69.

  15. Martínez A, Sainz B, Ramos B, Pacheco E, Zorio B, Castañeda G. Infarto agudo con elevación del ST en el servicio de urgencias del Instituto de Cardiología.RevCub de Cardiol y CirugíaCardiov. 2017; 23(1).

  16. Kennelly B. A etiology and risk factors in young patients with recent acute myocardial infarction. S Afr Med J. 2016; 61:503–507.

  17. Soleimani A, Karimi A, Sadeghian S, Darabian S; Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age. Monaldi Arch Chest Dis. 2015: 72(2):71-76.

  18. Poll J, Rueda N, Poll N. Caracterización clínico epidemiológica del síndrome coronario agudo según sexo. MEDISAN 2017; 21(10):3027-34.

  19. Correa A, Macías M, Robledo R, Ramírez J, Hernández J. El Infarto agudo del miocardio en pacientes jóvenes. MedIntMex. 2016; 19(1):3-7.

  20. Garcia L, Ramirez J, Llanes M, Trujillo J, Alegret M. Estudio de la cardiopatía isquémica en pacientes menores de 45 años.CorSalud(revista en internet) 2016. Disponible en:http//bvs.sld.cu/revista/cors/sumario/v1n4/estudio.htm.

  21. Hbejan K. Smoking Effect on Ischemic Heart Disease in Young Patients. Heart Views. 2015; 12:1-6.

  22. Marín F, Ospina L. Infarto agudo del miocardio en adultos jóvenes menores de 45 años. Rev. Col. Cardiol. 2015; 11(4):193-204.

  23. Kilver M, Bruckman D, UsonR,Bouthelier T. Epidemiologia y factores de riesgo en el infarto agudo del miocardio. Disponible en: www.sac.org.ar/rac/2010/v4 b/cg-1.pdf.

  24. Li G, Zhang P, Wang J, An Y, Gong Q, Gregg EW. Cardiovascular mortality, all-cause mortality and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da QING Diabetes Prevention Study. Lancet Diabetes Endocinol. 2014; 2:474-80.

  25. Medrano M, Pastor M, Boix R, Del Barrio J, Damián J, Álvarez R, et al. Riesgo coronario atribuible a los factores de riesgo cardiovascular en población española. RevEspCardiol. 2014; 60:1250-56.

  26. Veronesi G, Gianfagna F, Giampaoli S, Chambles LE, Mancia G, CesanaG.Improving long-term prediction of first cardiovascular event: the contribution of family history of coronary heart disease and social status. Prev Med. 2014; 64: 75-80.

  27. Godoy A. Doron D, Muñoz M. Infarto Agudo de Miocardio en pacientes menores de 50 años. Arch.Cardiol.Méx, 2015; 76(3): 12-120.

  28. Fournier J, Sánchez A, Quero J, Normal angiogram after myocardial infarction in Young patients: a prospective clinical-angiographic and long-term follow-up study. Int J Cardiol 2017; 60:281-88.

  29. Barranco D, Artucio C. Angioplastia Primaria en el infarto agudo del miocardio. Comite de Hemodinamia. SOC Rev. Urug. Cardiol. 2017;32:141-149.

  30. Romagnoli E, Biondi G, Sciahbasi A, Politi L, Rigattieri S, Pendenza G, et al. Radial Versus Femoral Randomized Investigation in STSegment Elevation Acute Coronary Syndrome The RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) Study. J Am CollCardiol 2016; 60(24):2481-9.

  31. Batista I, Alonso S, Mayol J. Angioplastia primaria en el infarto agudo de miocardio. Revista Uruguaya de Cardiología. Volumen 28 | nº 3 | Diciembre 2015.

  32. Suarez M, Escalona Y. Caracterización del infarto agudo del miocárdico en pacientes atendidos en Centro Médico Diagnóstico Integral Ezequiel Zamora de Venezuela. 2015. Citado:07-01-2016;19(4):680.

  33. Puricel S, Lehnerb C, Oberhånslia M, Rutz T, Tognib M, Stadelmanna M, et al. Acute coronary syndrome in patients younger than 30 years. Routine early angioplasty after fibrinolysis for acute myocardial infarction Swiss.Med.Wkly. 2016; 143(5): 334-45.

  34. Morillas J,CabadésA, Bertomeu V, Echanove I, Colomina F, Cebrián J, et al, en representación de los investigadores del PRIMVAC Infarto agudo de miocardio en pacientes menores de 45 años. Sección de Cardiología. Hospital Universitario de San Juan. Alicante. España.2016.

  35. Moreno E, Pérez A, Herrero I, Usón T, Placer L. Características clínico-funcionales en pacientes fumadores con infarto agudo de miocardio y su situación a los 5 años. Prevención del tabaquismo. 2016; 8(4):148-55.

  36. O’ Gara P, Kushner F, Ascheim D, Casey D, Chung M, De Lemos J, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. Circulation. 2016; 127(4):362-425.

  37. Bel G, HornungR.Acute myocardial infarction in young adults: causes and management. Postgrad Med J. 2017; 78:27–30.

  38. Planas A, Pomar F, Vilar J. Resultados clínicos y angiográficos tardíos de stent liberadores de fármacos en pacientes con infarto agudo del miocardio con elevación del ST. RevEspCardiol. 2015; 61:360-68.

  39. Neuman FJ, KastatriA,Schmitt C, Blasini R, Dibra A, et al. Metal-Analysis of randomized trials on drugs eluting stent vs. bare-metal stents in patients with acute myocardial infarction (ISAR-2). Eur Heart J. 2016; 28:2706-13.

  40. Levine G, Bates E, Blankenship J, Bailey S, Bittl J, Cercek B, et al. 2016 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am CollCardiol 2016; 58: e44-122.

  41. Su K,Cheng Z, Yang M, Shen JZ, Xie Z, Liu Y, Zeng Y et al. Clinical and coronary characteristics of young patients (< 30 years old) with acute myocardial infarction. YAMIS Studies. 2016; 38(12):1081-84.

  42. Bazz J, Mauri R. Registro Español De Hemodinamia y Cardiología Intervencionista. Rev. Esp. Cardiol. 2017; 60:1273-89.

  43. Stone G, Witzenbichler B, Guagliumi G, Peruga J, Brodie B, Dudek D, et al. Comparison of bivalirudin to heparin plus glycoproteinIib/IIIainhibitorsduringpercutaneouscoronaryintervention in acute myocardial infarction. HORIZONS-AMI Trial Investigators. N Engl J Med 2008; 358: 2218-30.

  44. Kloner R. No-Reflow Phenomenon: Maintaining Vascular Integrity. J of cardiovasc.FarmTerp. 2016; 4: 244-50.




2020     |     www.medigraphic.com