젊은 연령에서 발생한 급성 심근경색증의 장기 추적 경과 관찰

Abstract

Background : The purpose of this study was to evaluate risk factors, angiographic characteris tics and long- term prognosis of young adults with myocardial infarction(MI). Methods : Of the 2,680 patients with a history of MI, there were 148 patients 40 years old(Group 1). Risk factors, angiographic characteristics, cardiac events and long- term prognosis of group 1 were compared with those of randomly selected 149 patients between 41 years to 70 years old(Group 2) for a mean follow- up duration of 38 months (1∼147 months). Cardiac events include death, reinfarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, congestive heart failure, stroke, and angina. Results : Smoker and male gender were more frequent in group 1(p< 0.001). In group 2, hypertension and diabetes were more frequently observed(p<0.001). Angiographically normal coronary arteries, nonobstructive disease(<70% stenosis) and single- vessel disease were more frequent in group 1 than those in group 2 (p< 0.001). There was no significant difference of overall survival at 7 years between the two groups(group 1; 95%, group 2; 89%, p> 0.05). If hospital deaths were excluded, the 7- year survival was better in group 1(group 1; 99%, group 2; 92%, p< 0.01). The cardiac event free survial at 7 years was not different between two groups(p>0.05). Although a better left ventricular(LV) systolic function (ejection fraction(EF) 40%) showed more favorable survival in group 2(EF40%: 94%, EF<40%: 80%, p<0.05), survival was not influenced by LV systolic function in group 1. Conclus ion : Young patients with MI have a more favorable long- term survival after discharge compared with that of the older patients regardless of LV sys tolic function. Cardiac event free survival was, however, not different between two groups.(Korean J Med 59:30- 39, 2000)