Myocardial Injury Non-Related Atherosclerotic Plaque Disruption in Patients Younger than 40 Years Old

AHMET SEYFEDDİN GÜRBÜZ, SEMİ OZTURK, SEFA TATAR, MEHMET AKİF DÜZENLİ, CEVAT KIRMA

  • Year : 2020
  • Vol : 36
  • Issue : 2
  •  Page : 116-122

Backround: Myocardial infarction with coronary artery disease (MICAD) is the leading cause of myocardial injury. Myocardial injury non-related to atherosclerotic plaque disruption (non-MICAD) is a rare and heterogeneous diagnosis. Although MICAD is well studied, non-MICAD was not thoroughly identified in young patient population. We aimed to investigate the frequency, main etiologies, and five-year mortality of patients with non-MICAD younger than 40 years.

Methods: We retrospectively enrolled 292 patients with acute myocardial injury younger than 40 years between January 2010 and December 2014. Clinical, demographic, laboratory, angiographic features, and five-year all-cause mortality were compared between patients with non-MICAD (n=78) and MICAD (n=214).

Results: Median age of patients was 36. Non-MICAD group was younger than MICAD group [32 (28-37) vs 37 (34-39)]. The frequency of female patients with non-MICAD was higher than those with MICAD (24.4% vs 10.3%). Most of the patients with MICAD presented with STEMI (77.1%), while most of the patients with non-MICAD presented with non-STEMI (89.7%). Most common etiologies of non-MICAD in were myocarditis (32%) and vasospasm (9%). Age, female sex, no smoking and, absence of dyslipidemia were independent predictors for non-MICAD. Five-year all-cause mortality in non-MICAD group was significantly lower than MICAD group (2.6% vs 10.3%) (log-rank test p=0.04).

Conclusion: Non-MICAD represents a heterogeneous group of patients who had varying etiologies at different ages. Despite the lower mortality rate of non-MICAD group, different diagnostic and treatment strategies are required for management of patients with non-MICAD.

Cite this Article As : Gurbuz AS, Ozturk S, Tatar S, Duzenli MA, Kirma C. Myocardial Injury Non-Related Atherosclerotic Plaque Disruption in Patients Younger than 40 Years Old. Selcuk Med J 2020;36(2): 116-122

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Description : None of the authors, any product mentioned in this article, does not have a material interest in the device or drug. Research, not supported by any external organization. grant full access to the primary data and, if requested by the magazine they agree to allow the examination of data.
Myocardial Injury Non-Related Atherosclerotic Plaque Disruption in Patients Younger than 40 Years Old
, Vol. 36 (2)
Received : 19.07.2019, Accepted : 19.07.2019, Published Online : 03.06.2020
Selçuk Tıp Dergisi
ISSN:1017-6616;
E-ISSN:2149-8059;