PURPOSE: There are various risk factors for coronary heart disease (CHD) and ST elevation myocardial infarction (STEMI), out of which the prevalence of obesity is increasing in epidemic proportions. Literature is sparse and there are few reports for the association of obesity and myocardial infarction in the young population. We present our hospital experience demonstrating the prevalence of various risk factors including obesity in young patients with STEMI.
METHODS: Retrospective chart review on all first event STEMI patients between December 2005 and July 2007 was performed. Young population was defined as: males < 45 years and females < 55 years of age. This definition of young was based on the age of risk for CHD in men and women and corresponded with the age recommended for treatment of dyslipidemia in men and women in the Adult Treatment Panel III report. Obesity was defined as body mass index ≥ 30 kg/m2.
RESULTS: Among 206 patients with STEMI, 36 were young. In young patients with STEMI, 78% (28 of 36) were obese compared with 35% (60 of 170) in non-obese (P<0.001). Also, among young patients with STEMI, family history of CHD was positive in 39% (14 of 36) compared with 19% (32 of 170) in non-young (P=0.009). After adjusting for other risk factors using logistic regression, both obesity and family history of CHD continued to be more prevalent in young compared to non-young STEMI patients (p < 0.0001, 95% C.I. 2.96 to 17.75 and p = 0.008, 95% C.I. 1.36 to 7.47 respectively).
CONCLUSIONS: Obesity and family history of CHD were major risk factors with a higher prevalence in young patients with STEMI than non-young patients.
CLINICAL IMPLICATIONS: Obesity was found to be the only modifiable independent risk factor in young patients with STEMI. Larger studies needed to confirm causal relationship between obesity and STEMI. Targeting young children and young adults for obesity screening and weight reduction can have significant impact in primary prevention of STEMI in young.
DISCLOSURE: The following authors have nothing to disclose: Abhijeet Basoor, John Cotant, Kiritkumar Patel, Gagan Randhawa, Mina Todorov, Abdul Halabi, Nishit Choksi, Ali Shafiq, Paul Stein, Michele DeGregorio
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