期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 143, 期 3, 页码 249-254出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2009.02.019
关键词
Young myocardial infarction; Prognostic markers; Coronary risk factors
资金
- Fundacion para la Formacion e Invastigacion Sanitarias de la Region de Murcia, Murcia, Spain
Background: Intravascular thrombogenesis is influenced by a complex interplay of factors related to a procoagulant state, fibrinolysis, endothelial damage/dysfunction and inflammation. We hypothesised that abnormalities of these biological systems would contribute to outcome of coronary artery disease presenting at a young age. Methods: We performed a prospective study of 142 subjects presenting with acute myocardial infarction (AMI) at a young age (defined as age <= 45 years), to determine the clinical and laboratory predictors of cardiovascular events during 36 months of follow-up. We assessed conventional risk factors and abnormalities of thrombophilia [total homocysteine (tHcy), lipoprotein (a) [Lp(a)], antiphospholipid antibodies (APA)], as well as lipid profile (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides), fibrinogen and fibrin D-dimer (as indices of a hypercoagulable state and thrombogenesis), von Willebrand factor (vWF, an index of endothelial damage/dysfunction), tissue plasminogen activator [t-PA antigen] and its inhibitor [PAI-1 antigen] (as indices of fibrinolysis), and C-reactive protein [CRP] (an index of inflammation). Results: In a multivariate analysis, the variables independently associated with cardiovascular events at follow-up were levels of homocysteine (OR 3.73, 95% CI (1.54-9.02); p= 0.003), left ventricle systolic dysfunction (OR 3.04, 95% CI (1.00-9.25); p= 0.050), and smoking habit (OR 2.79, 95% CI (1.09-7.14) p= 0.032). Conclusions: Prognostic markers associated with cardiovascular events in premature CAD (young AMI subjects) were cigarette smoking and EF<50% of left ventricle as conventional clinical risk factors, as well as higher levels of homocysteine. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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