4.7 Review

Causes, Angiographic Characteristics, and Management of Premature Myocardial Infarction JACC State-of-the-Art Review

Journal

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 79, Issue 24, Pages 2431-2449

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2022.04.015

Keywords

cocaine; MINOCA; premature myocardial infarction; SCAD; smoking

Funding

  1. Amgen
  2. ELPEN
  3. Sanofi
  4. Mylan
  5. Novartis
  6. Servier
  7. Bayer Hellas
  8. Boston Scientific
  9. GE Healthcare
  10. Abbott
  11. Edwards Lifesciences
  12. Daiichi-Sankyo
  13. Concept Medical
  14. National Institutes of Health
  15. Boehringer Ingelheim
  16. CSL Behring
  17. Ferring Pharmaceuticals
  18. Bayer

Ask authors/readers for more resources

The proportion of young individuals with acute myocardial infarction (AMI) has increased in recent years. Despite less extensive coronary atherosclerosis, young AMI patients still have poor long-term prognosis. They share similar risk factors with older patients for obstructive coronary artery disease, except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Nonobstructive coronary artery myocardial infarction is relatively common among young AMI patients, requiring specific diagnostic and treatment approaches.
Among patients presenting with acute myocardial infarction (AMI), the proportion of young individuals has increased in recent years. Although coronary atherosclerosis is less extensive in young patients with AMI, with higher prevalence of single-vessel disease and rare left main involvement, the long-term prognosis is not benign. Young patients with AMI with obstructive coronary artery disease have similar risk factors as older patients except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Smoking cessation is by far the most effective secondary preventive measure. Myocardial infarction with nonobstructive coronary arteries is a relatively common clinical entity (10%-20%) among young patients with AMI, with intravascular and cardiac magnetic resonance imaging being key for diagnosis and potentially treatment. Spontaneous coronary artery dissection is a frequent pathogenetic mechanism of AMI among young women, requiring a high degree of suspicion, especially in the peripartum period. (C) 2022 by the American College of Cardiology Foundation.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available