Risk factors profile of young and older patients with Myocardial Infarction.

Published on Aug 6, 2021in Cardiovascular Research10.787
· DOI :10.1093/CVR/CVAB264
Marios Sagris5
Estimated H-index: 5
(UoA: National and Kapodistrian University of Athens),
Alexios S. Antonopoulos30
Estimated H-index: 30
(University of Oxford)
+ 7 AuthorsDimitris Tousoulis47
Estimated H-index: 47
(UoA: National and Kapodistrian University of Athens)
Myocardial infarction (MI) among young adults (< 45 years) represents a considerable proportion of the total heart attack incidents. The underlying pathophysiologic characteristics, atherosclerotic plaque features and risk factors profile differ between young and older patients with MI. This review article discusses the main differences between the younger and elderly MI patients as well as the different pathogenic mechanisms underlying the development of MI in the younger. Young patients with MI often have eccentric atherosclerotic plaques with inflammatory features but fewer lesions, and are more likely to be smokers, obese, and have poor lifestyle, such as inactivity and alcohol intake. Compared to older MI patients, younger are more likely to be men, have familial-combined hyperlipidemia and increased levels of lipoprotein-a. In addition, MI in younger patients may be related to use of cannabis, cocaine use and androgenic anabolic steroids. Genomic differences especially in the pathways of coagulation and lipid metabolism have also been identified between young and older patients with MI. Better understanding of the risk factors and the anatomic and pathophysiologic processes in young adults can improve MI prevention and treatment strategies in this patient group. Awareness could help identify young subjects at increased risk and guide primary prevention strategies. Additional studies focusing on gene pathways related to lipid metabolism, inflammation and coagulation are needed.
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