Acute myocardial infarction among young adults under 40 years of age. Risk factors, clinical and angiographic characteristics

Abstract

Coronary artery disease is becoming more frequent in young adults with specificities of its own. It is considered as a singular entity, and yet not exceptional one. Methods: We conducted a retrospective study in the Cardiology Depratment B of ibn Sina Hospital in Morocco, Rabat between January 2011 and December 2018. The study included all patients admitted with a diagnosis of myocardial infarction and whose age was equal or less than 40 years. The statistical analysis was performed using SPSS Software. Results: In the study period, 80 patients were included. We separated patients in 2 groups: group I with obstructive coronary artery disease (49 patients) and group II with nonobstructive coronary artery disease (31 patients). Smoking and substance abuse were significantly predominant in patients of group I with respectively (73.5% vs 41.9%; p = 0.005; 53.1% vs 22.6%; p = 0.007). Moreover, patients of group II had less hypertension and dyslipidaemia and prodromal symptoms (28.6% vs 6.5%; p = 0.01; 24.5% vs 3.2%; p = 0.01; 32.7% vs 12.9%, p = 0.047) and the absence of cardiac risk factors in group II was significant (p < 0.001). Single-vessel involvement was predominant (43.5%) in group I and angiographic findings in group II showed: myocardial bridge (1.25%), coronary aneurysm (1.25%), vasospasm (2.5%), non-significant lesions (13.75%) and normal arteries in 20%. Conclusion: The prevention of risk factors remains the cornerstone of the treatment, especially smoking and drug use among young Moroccan population. The multiple aetiologies found in this young population induce an aetiology-targeted management along with the conventional treatment.