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PROGNOSTIC FACTORS FOR IN-HOSPITAL MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS UNDER 40 YEARS OLD WITH ACUTE CORONARY SYNDROME
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Abstract
Background: Acute coronary syndrome (ACS) is increasingly seen in younger patients, who often present with distinct risk profiles and clinical features. Identifying prognostic factors is essential for personalized management in this group. Objectives: To evaluate clinical characteristics, laboratory findings, and in-hospital prognostic factors in ACS patients aged ≤ 40 years. Methods: A retrospective study on ACS patients aged 18–40 who underwent coronary angiography/intervention at Chợ Rẫy Hospital from April 2021 to April 2024. Results: A total of 120 patients (median age: 36; 89.2% male, male:female = 9:1). Common risk factors: overweight/obesity (67.5%), dyslipidemia (62.5%), smoking (37.5%). STEMI was most frequent (64.2%), most presented with Killip I (83.3%), with single-vessel disease (67.5%) mostly in LAD (66.7%). In-hospital major adverse cardiovascular events (MACE) occurred in 12.5%: mortality (3.3%), acute heart failure (4.2%), life-threatening arrhythmia (4.2%), mechanical complications (0.8%). GRACE score was an independent predictor (OR 1.11; p<0.001). A cutoff of GRACE ≥ 89 had AUC > 0.8, sensitivity 73.3%, specificity 97.1%. Conclusions: Young ACS patients are predominantly male, often present with STEMI, Killip I, and single LAD lesions. GRACE ≥ 89 is a strong predictor of in-hospital MACE.
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Keywords
Acute coronary syndrome, young patients, prognostic factors.
References
2. Revaiah PC, Vemuri KS, Vijayvergiya R, et al. Epidemiological and clinical profile, management and outcomes of young patients (≤40 years) with acute coronary syndrome: A single tertiary care center study. Indian Heart Journal. 2021/05/01/ 2021;73(3):295-300. doi: https://doi.org/10.1016/j.ihj.2021.01.015
3. P T, M G, M G, et al. In-hospital and 12-month outcomes after acute coronary syndrome treatment in patients aged<40 years of age (from the Polish Registry of Acute Coronary Syndromes). The American journal of cardiology. Jul 15 2014;114(2): 175-80. doi:10.1016/ j.amjcard.2014.04.024
4. Minh HV, Bình HA, Anh ĐT. Nghiên cứu một số yếu tố nguy cơ, đặc điểm lâm sàng, cận lâm sàng, tổn thương mạch vành ở bệnh nhân hội chứng vành cấp dưới 40 tuổi. Tạp chí Y Dược học - Trường Đại học Y Dược Huế. 2020;10(2):26-32.
5. Quang Vũ N, Văn Truyền N. Đặc điểm lâm sàng, cận lâm sàng, kết quả điều trị bệnh nhân nhồi máu tơ tim cấp dưới 40 tuổi. Tạp chí Y Dược học Cần Thơ. 05/31 2023; (59):33-38. doi:10. 58490/ctump.2023i59.1622
6. B R, E C, Z V, et al. Acute Coronary Syndrome: The Risk to Young Women. Journal of the American Heart Association. Dec 22 2017;6(12): e007519. doi:10.1161/jaha.117.007519
7. A W, A S, D B, H S, A M, P N. Clinical & angiographic profile of young patients (<40 years) with acute coronary syndrome. Journal of Indian College of Cardiology. 2014;4(2):95-100. doi:10.1016/j.jicc.2014.02.009
8. P P, K S, I A-Z, S A. Acute coronary syndrome in young adults from oman: results from the gulf registry of acute coronary events. Heart Views. Oct 2010;11(3): 93-8. doi:10.4103/1995-705x. 76799
9. N V, J A. Clinical and Angiographic Profile of Acute Coronary Syndrome Patients (<40 Years) and Short-Term Prognosis: A Cross-Sectional Study. Journal of the Practice of Cardiovascular Sciences. 2021;7(3):225-229.