الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 131 |  |  |
| | | from | 131 | | |
Abstract
Younger patients with coronary heart disease < 45 years is defined as premature coronary artery disease which has different etiological factors, clinical presentation and angiographic finding from mature patients. The present study comprised 150 young age patients (less than 45 years old) who presented with acute myocardial infarction in our Cardiovascular Department at Mansoura Specialized Internal Medicine Hospital between january 2017 and january 2018 as prospective study. The protocol was approved by our ethical committee and written consent was taken from the study subject. This study is conducted to evaluate clinical condition and risk factors among young patients presented with acute myocardial infarction. We excluded Patients who refuse to sign a consent to share the study, Patients age more than 45 years old and Patients with inadequate data. In our study we found that males were more affected with premature CAD. Regarding risk factors, smoking was significantly increased among patients with premature CAD. While prevalence of hypertension, diabetes mellitus, family history of CAD and the presence of multiple risk factors (3 risk factors) were insignificant among young age patients with acute myocardial infarction. Addiction is also a major risk factor after smoking that was significantly high among our study by 52 %. High serum homocysteine was significant finding in our study by 50%. Homocysteine level was significantly high in acute MI patients. The findings support the hypothesis that homocysteine level may be an independent risk factor for coronary artery disease. High serum ferritin was important finding in our study by 34 %. These findings indicate that serum ferritin is positively associated with CAD risk. This risk needs to be confirmed by further studies. In our study ECHO evaluation shows statistically significant increase in EF among young age patients presented with acute myocardial infarction than patients with mature CAD according to previous international studies. Also, ECHO evaluation revealed significant increase in anterior wall RSWMA than inferior wall and lateral wall and this is due to dominance of anterior STEMI in our study. Younger patients with CAD had a different risk factor profile. Smoking is the most prevalent cardiac risk factor in the young patients followed by addiction and hyperlipidemia and with less prevalence of diabetes mellitus and hypertension. Young patients of CAD have less extensive disease. Single vessel involvement particularly the left anterior descending artery were more common in the premature CAD patients.