scholarly journals Proteomic Profiles of Young Adults with Acute Myocardial Infarction

2020 ◽  
Vol 18 (3) ◽  
Author(s):  
Mohamed Bakrim N ◽  
Mohd Shah AS ◽  
Mohd. Shah ANS ◽  
A. Talib N ◽  
A.Rahman J ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Young Patients ◽  
Specific Protein ◽  
Proteomic Profiling ◽  
Protein Biomarkers ◽  
Multifactorial Diseases ◽  
Control Subjects ◽  
Apo Ai

Introduction: Proteomic profiling is essential in understanding the pathophysiological process of multifactorial diseases such as acute myocardial infarction (AMI). Despite the increasing incidence of AMI in young adults, proteomic-based study focusing on young AMI remains limited. This study aimed to examine the plasma proteomic profiles of young adults with AMI compared to control subjects. We also hope to identify disease-specific protein biomarkers that contribute to the development of AMI in the young. Methods: Pooled plasma protein from 10 AMI patients aged 18 to 45 years and 10 age, gender and race - matched volunteers were separated using two-dimensional electrophoresis (2-DE). The spots proteins were analysed using the PD Quest analysis software. The spots proteins that were found to have been expressed differently between the two groups were identified by Matrix Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry. Results: There were three differently expressed proteins namely Apolipoprotein AI (Apo AI), Apolipoprotein AIV (Apo AIV) and Haptoglobin (p < 0.05). The expressions of these proteins were found to be increased in young patients with AMI compared to control subjects. Conclusion: The up regulation of Apo AI, Apo AIV and Haptoglobin in AMI patients indicate their important roles in the development of atherosclerotic disease. Thus, Apo AI, Apo AIV and Haptoglobin are potential disease biomarkers for young AMI.

scholarly journals Proteomic Profiles of Young Adults with Acute Myocardial Infarction

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Norbaiyah Mohamed Bakrim ◽  
Azarisman Shah Mohd Shah ◽  
Aida Nur Sharini Mohd. Shah ◽  
Norlelawati A. Talib ◽  
Jamalludin A. Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Young Patients ◽  
Molecular Study ◽  
Specific Protein ◽  
Protein Biomarkers ◽  
Control Subjects ◽  
New Biomarkers ◽  
Apo Ai

Introduction: The incidence of acute myocardial infarction (AMI) in young adults is increasing. However, a molecular study focusing on the pathophysiological changes in young AMI remains limited. This study aims to examine the proteomic profile of young adults with AMI compared to control subjects. We also hope to identify disease-specific protein biomarkers that contribute to the development of AMI in the young. Materials and Methods: Pooled plasma protein from 10 AMI patients aged 18 to 45 years and 10 age, gender and race-matched volunteers were separated using two dimensional electrophoresis (2-DE). The protein spots were analysed using the PD Quest analysis software. The protein spots that were found to have been expressed differently between the two groups were identified by Matrix Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry. Results: There were three differently expressed protein spots, namely Apolipoprotein AI (Apo AI), Apolipoprotein AIV (Apo AIV) and Haptoglobin. The expressions of these proteins were found to be increased in young patients with AMI compared to control subjects (p&lt; 0.05). Conclusion:The up-regulation of Apo AI, Apo AIV and Haptoglobin in AMI patients could be in response to the inflammatory process associated with the recent cardiac event. The current study seems to reveal a significant function of these proteins during the acute phase response. Thus, Apo AI, Apo AIV and Haptoglobin are potential new biomarkers for young AMI.

scholarly journals Acute myocardial infarction in young adults: features of pathogenesis, disease course and justification of strategy for prevention of complications

2019 ◽  
Vol 26 (4) ◽  
pp. 32-43
Author(s):  
O. M. Parkhomenko ◽  
Ya. M. Lutay ◽  
O. I. Irkin ◽  
D. O. Bilyi ◽  
A. O. Stepura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Young Patients ◽  
Coronary Vessels ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Premature Coronary Artery Disease ◽  
Ventricular Ejection Fraction ◽  
Arrhythmogenic Substrate

We retrospectively and prospectively studied 835 patients with acute myocardial infarction (AMI) under the age of 45 and older. Depending on age, patients were divided into two groups: < 45 years and ≥ 45 years. In 189 patients under 45 years of age, the main risk factors leading to the development of ST-elevation myocardial infarction were male sex (OR 6.58; 95 % CI (2.64–16.41), smoking (OR 2.02; 95 % CI (1.44–2.82) and family history of premature coronary artery disease (OR 1.75; 95 % CI (1.21–2.54). According to coronary angiography, AMI patients under 45 years of age in most cases showed no hemodynamically significant coronary vessels damage and had a different course of AMI caused by other reasons – aneurysms of the coronary arteries, muscle bridges, coronary spasm, spontaneous dissections. It was found that 10 % of young patients who did not have obstructive lesions of coronary vessels, according to magnetic resonance imaging (MRI) had focal myocarditis. However, it is noted that in patients under 45 years of age, the presence of familial hypercholesterolemia (FH) may affect the development of AMI. Thus, according to the DLCNS criteria, FH was more frequently reported in young patients than in patients older than 45 years (7.34 % vs 1.32 % (p<0.05)). Hospital course of AMI in young adults was more favorable, with fewer complications. Data from studies of flow-dependent vasodilation have shown that young patients have worse endothelial function on the 1st day of AMI (p=0.043), but better recovery of it in the dynamics of observation. However, in young patients, early (day 7, p=0.029) and late (day 90, p=0.041) left ventricular dilatation was more commonly reported compared with older patients. According to the MRI data on day 1 and in the dynamics (90 days), it was found that, despite the higher prevalence of AMI, young patients have better recovery of contractile myocardial function. The arrhythmogenic substrate (according to late ventricular potential) for life-threatening arrhythmias was more commonly recorded in the older age group at the beginning of the development of AMI, but it was detected with the same frequency in both groups during prolonged observation (6–12 months). Despite better survival and fewer complications during long-term follow-up (4.9 years on average), the greatest impact on the development of the combined endpoint (cardiovascular death / recurrent myocardial infarction / stroke) and death from any cause was made by the patients’ age up to 35 years (best prognosis), concomitant hypertension (worsens prognosis) and low left ventricular ejection fraction (increases complications). The study indicates the possibility of implementing a secondary prevention system in AMI patients of young age through careful (active) observation and control of adherence to treatment and the adequacy of its implementation.

scholarly journals Coronary lesions suggestive of kawasaki disease in young patients presenting with acute myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Solis-Jimenez ◽  
H Gonzalez Pacheco ◽  
J Calderon Colmenero ◽  
J Cervantes Salazar ◽  
D Manzur Sandoval ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Clinical Characteristics ◽  
Young Patients ◽  
Coronary Aneurysms ◽  
Coronary Lesions

Abstract Background Approximately 25% of patients with untreated Kawasaki disease (KD) in childhood develop coronary aneurysms, which represent a higher likelihood for the occurrence of acute myocardial infarction (AMI) in young adults. Although the clinical characteristics of young adults with KD and suspected ischemia have been studied, the available data about suggestive lesions of KD in AMI is scarce. Purpose To describe the prevalence, clinical characteristics and in-hospital mortality of young adults with AMI and coronary artery lesions suggestive of KD. Methods We conducted a retrospective study of consecutive ≤40-year old patients hospitalized with AMI and coronary angiography in a coronary care unit of a Mexican teaching hospital between 2006–2020. Patients were classified according to the presence or absence of suggestive lesions of KD sequelae such as proximal aneurysms, larger size and normal distal segments Results There were included 488 patients of 40 years of age and younger, diagnosed with AMI, in whom a coronary angiography was performed. Among them, 44 patients (9%) showed coronary aneurysm or ectasia, within this group, 16 patients (36.3%) had angiographic lesions compatible with KD. The patients were classified according to the type of coronary lesions: Angiographic lesions compatible with KD, 3.3% (n=16); Diffuse coronary artery ectasia (CAE), 5.7% (n=28); and Obstructive coronary disease (OCD), 91% (n=444). The prevalence of smoking, dyslipidemia, and hypertension were similar between the groups, whereas a history of diabetes was absent in KD patients (0%, 10.7%, and 22.1% for KD, CAE and OCD, respectively; P=0.04). At admission, ST-elevation myocardial infarction was more frequent in patients with KD (81.3%, 75%, and 67.1% for KD, CAE and OCD, respectively; P=0.35). More than half of patients with KD had coronary aneurysms in two or more vessels. The right coronary artery was the most commonly affected artery followed by the left anterior descending artery and left circumflex coronary artery (87.5%, 56.3% and 56.3%, respectively). The presence of intracoronary thrombus identified at the time of angiography was more frequent in patients with KD (62.5%, 60.7% and 44.1% for KD, CAE and OCD, respectively; P=0.09). Overall, unadjusted in-hospital mortality was 3.9% and there were no deaths in the KD group (0%, 0% and 4.3% for KD, CAE, and OCD, respectively; P=0.37). Conclusion In young patients with AMI, the sequelae of KD should be considered as a possible etiology, based on their angiographic characteristics. To bear in mind the nature of the pathogenesis is crucial to assess medical and interventional management strategies, which are not well defined yet, in order to evaluate cardiovascular risk and optimize a patient-tailored treatment, which could differ from the treatment of atherosclerotic coronary artery disease FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

Abstract 16899: Sex Differences in Young Adults With Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Malini Nadadur ◽  
Rikin Tank ◽  
Cheng Chen ◽  
Anne ICHIUJI ◽  
Yuh-Jer A Shen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Sex Differences ◽  
Clinical Characteristics ◽  
Obstructive Coronary Artery Disease ◽  
Young Patients ◽  
Men And Women ◽  
Patients Âgés

Introduction: There are important sex differences in the pathophysiology and clinical presentation of cardiovascular disease. Cardiovascular disease is understudied in women, despite it being the leading cause of mortality. The goal of this study is to report sex differences in clinical characteristics, treatment, and outcomes in young patients presenting with acute myocardial infarction. Methods: This is a retrospective observational study that included patients ages 18 to 40 hospitalized for acute myocardial infarction between 2006 and 2016 in Kaiser Permanente Southern California, a large integrated healthcare system. Differences in demographics, clinical characteristics, and management were examined between men and women. Multivariable Cox proportional hazard models were used to examine the association between sex and mortality. Results: Between 2006 and 2016, a total of 26,390 patients were hospitalized with a principal diagnosis of acute myocardial infarction and underwent coronary catheterization. In this cohort, 603 patients were young adults between age 18 to 40, of whom 144 (24%) were women. Women were more likely to be black. There were no significant sex differences in the prevalence of hypertension, hyperlipidemia, diabetes, heart failure and renal failure. There was a higher prevalence of obesity in women. Women were more likely to have no obstructive disease on coronary angiogram (43.4% vs. 33.2%, p=0.03). Treatment with percutaneous coronary intervention was less likely in women (38.2% vs. 56.2%, p<0.001). Mortality was low for both women and men during index hospitalization (0.7% vs 0.9%, p=0.84) and at one year (1.4% vs. 1.5%, p=0.91), with no significant differences (adjusted HR 1.3, 95% CI 0.5-3.1). Conclusions: Compared to young men, young women presenting with acute myocardial infarction as less likely to have obstructive coronary artery disease. Mortality rates for both men and women were low, with no significant differences observed.

Synergistic Effect of Thrombomodulin Promoter -33G/A Polymorphism and Smoking on the Onset of Acute Myocardial Infarction

2002 ◽  
Vol 87 (01) ◽  
pp. 86-91 ◽  
Author(s):  
Yi-Heng Li ◽  
Wei-Chuan Tsai ◽  
Ting-Hsing Chao ◽  
How-Ran Guo ◽  
Liang-Miin Tsai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Patients ◽  
Single Strand Conformation Polymorphism ◽  
Cell Surface Receptor ◽  
Endothelial Cell Surface ◽  
Control Subjects ◽  
Increased Risk ◽  
Surface Receptor ◽  
Independent Risk Factors

SummaryThrombomodulin is an endothelial cell surface receptor for thrombin. It plays an important role in the regulation of blood coagulation by decreasing thrombin activity and activating protein C. This study examined the possible association between the thrombomodulin -33G/A polymorphism and acute myocardial infarction. We recruited 278 patients (mean age 57.5 years, 241 men) with documented myocardial infarction and 450 age-and sex-matched control subjects. Polymerase chain reaction and single-strand conformation polymorphism was used to define the thrombomodulin -33G/A polymorphism. The frequency of the thrombomodulin GA+AA genotype among patients with myocardial infarction was higher than that in control subjects (22.7% vs. 16.2%, odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0 to 2.2). The -33G/A polymorphism (GA+AA genotype) was significantly associated with myocardial infarction (OR 1.6, 95% CI 1.1 to 2.5) as was hypertension, diabetes mellitus and smoking. Among young myocardial infarction patients (age ≤45 years, n = 72), the frequency of -33G/A polymorphism was more significantly higher than that in control subjects (29.2% vs. 16.2%, OR 2.1, 95% CI 1.2 to 3.8). The -33G/A polymorphism (OR 2.3, 95% CI 1.3 to 4.1) and smoking (OR 4.5, 95% CI 2.5 to 7.9) were the only independent risk factors for young myocardial infarction. Furthermore, among patients who did not smoke, the polymorphism was associated with a nonsignificant increase in the risk of young myocardial infarction (OR 1.9, 95% CI 0.6 to 5.6); whereas, in the presence of smoking, the increase was statistically significant (OR 2.3, 95% CI 1.2 to 4.7). Smoking carriers of the thrombomodulin -33G/A polymorphism had a nearly 10-fold increased risk of young myocardial infarction (OR 9.8, 95% CI 4.3 to 22.4) when compared with nonsmoking non-carriers. We concluded that there was a significant association between the thrombomodulin -33G/A polymorphism and myocardial infarction in our population, especially in young patients. The clinical effect of this genetic factor was enhanced by smoking.

Abstract P375: Decade Long Trends in the Magnitude, Treatment, and Outcomes of Young Adults Hospitalized with ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mayra Tisminetzky ◽  
Jennifer Coukos ◽  
David McManus ◽  
Chad Darling ◽  
Samuel Joffe ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Young Patients ◽  
Term Survival ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Elevation Acute Myocardial Infarction

Background: Although acute myocardial infarction (AMI) occurs primarily in the elderly, this disease also affects young adults. Few studies have, however, presented data on relatively young patients hospitalized with AMI. The objectives of this population-based study were to examine recent trends in the magnitude, management, and in-hospital and long-term-outcomes associated with either an initial ST-segment elevation acute myocardial infarction (STEMI) or non-ST-segment elevation acute myocardial infarction (NSTEMI) in patients between the ages of 30-54 years old. Methods: We reviewed the medical records of 745 residents of the Worcester (MA) metropolitan area between the ages of 30 and 54 years who were hospitalized for an initial STEMI or NSTEMI in 6 annual periods between 1997 and 2007 at 11 greater Worcester medical centers. Results: Between 1997 and 2007, the proportion of young adults hospitalized with an initial STEMI decreased from approximately two-thirds to two-fifths of all patients. Patients with STEMI were less likely to have a history of heart failure, hypertension, hyperlipidemia, and kidney disease than NSTEMI patients. Both groups were similarly treated with evidence-based therapies during their acute hospitalization with encouraging trends in the prescribing of various cardiac medications observed over time (Figures 1A and B). Important in-hospital clinical complications and mortality were low and no significant differences in these endpoints were observed between STEMI and NSTEMI patients. One year post-discharge death rates were also similar in both groups (1.9% vs. 2.8%). Conclusion: The present results demonstrate recent decreases in the proportion of relatively young patients diagnosed with an initial STEMI. Patients with STEMI and NSTEMI had similar in-hospital outcomes and long-term survival. Trends in these and other important outcomes warrant continued monitoring.

The impact of sex, gender and healthcare system on quality of care among young adults with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Raparelli ◽  
L Pilote ◽  
H Behlouli ◽  
J Dziura ◽  
H Bueno ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Quality Of Care ◽  
Healthcare System ◽  
Quality Indicators ◽  
Funding Source ◽  
Post Discharge ◽  
Single Payer

Abstract Background The quality of care among young adults with acute myocardial infarction (AMI) may be related to biological sex, psycho-socio-cultural (gender) determinants or healthcare system-level factors. Purpose To examine whether sex, gender, and the type of healthcare system influence the quality of AMI care among young adults. Methods A total of 4,564 AMI young adults (&lt;55 years) (59% women, 47 years, 66% US) were analyzed from the VIRGO and GENESIS-PRAXY studies consisting of single-payer (Canada, Spain) versus multipayer (US) systems. For each patient treated in each system we calculated a quality of care score (QCS) for pre-AMI (1-year pre admission), in-hospital, and post-AMI (1-year post discharge) phases of care (number of quality indicators received divided by the total number [range=0–100%], with higher scores indicating better quality). Ordinal logistic or linear regression models, and 2-way interactions between sex, gender and healthcare system were tested. Results Women in the multipayer system had the highest risk factor burden. Across the phases of care for AMI, 20% of quality indicators were missed in both sexes. High stress, earner status, and social support were associated with a higher QCS in the pre-AMI phase, whereas only employment and earner status were associated with QCS in all other phases. In the pre-AMI phase, women had higher QCS than men, mainly in the single-payer system (adjusted-OR=1.85, 95% CI 1.46,2.35 vs. 1.07, 95% CI 0.84,1.36, P-interaction= 0.002). Regardless of sex, only employment status had a greater effect in the multipayer system (adjusted-OR=0.59, 95% CI 0.44,0.78 vs 1.13, 95% CI 0.89,1.44, P-interaction &lt;0.001). In the in-hospital phase, women had a lower QCS than men, especially in the multipayer system (adjusted-mean-difference: −2.48, 95% CI-3.87, −1.08). Employment was associated with a higher QCS (2.0, 95% CI 0.9–3.17, P-interaction &gt;0.05). Finally, in the post-AMI phase, men and women had a lower QCS, predominantly in the multipayer system. However, primary earners had higher QCS regardless of system. Conclusion Sex, gender, and healthcare system affected the quality of care after AMI. Women had a poorer in-hospital than men and both women and men had suboptimal post-discharge care. Being unemployed lowered the quality of care, more so in the multipayer system. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Canadian Institutes of Health and Research (CIHR)

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