scholarly journals Comparison of Different Risk Factors and Coronary Angiographic Profile in Younger and Older Patients with Ischeamic Heart Disease

2015 ◽  
Vol 8 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Kazi Nazrul Islam ◽  
Abdul Wadud Chowdhury ◽  
Azizul Hasan Khandaker ◽  
Khandker Md Nurus Sabah ◽  
Md Gaffar Amin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Older Patients ◽  
Homocysteine Level ◽  
Young Patients ◽  
High Serum ◽  
Younger Patients ◽  
Vessel Disease ◽  
Serum Homocysteine ◽  
Group I

Background: Due to socio-economic improvement and changes in the life style, ischeamic heart disease is becoming a major burden to our health care system. In recent years, the incidence is increasing among younger age groups as well.Methods: A total of 120 patients with ischeamic heart disease admitted for coronary angiogram were included in the study and were divided into two groups. Among them, 60 younger patients were in Group-I (d” 40 years of age); 60 older patients in Group-II (>40 years of age). We compared demographic profiles, different risk factors and angiographic profiles between two age groups.Results: Among the common risk factors, smoking (63.3% vs 40%, p=0.011) & family history of ischeamic heart disease (21.7% vs 8.3%, p=0.040) were more common in younger group. Whereas, hypertension (41.7% vs 65.0%, p=0.010) and DM (18.3% vs 36.7%, p=0.024) were more common in older patients. Serum Homocysteine level was found significantly higher in younger patients (30.0% vs 13.3%, p=0.026). In group-I. coronary angiography revealed normal coronaries in 15 patients (25%), single vessel disease in 29 (48.3%) and multi-vessel disease in 16 patients (26.6%). Whereas, 40(66.6%) patients in group-II were found to have multi-vessel disease and 2 of them had significant left main coronary disease. However, young patients who had high serum homocysteine level showed more angiographic severity than older patients.Conclusion: There are significant differences in the clinical, biochemical and angiographic profile of young patients with ischeamic heart disease as compared to older patients. Young patients with ischeamic heart disease has got less angiographic severity, except in those with high serum homocysteine level.Cardiovasc. j. 2015; 8(1): 23-29

Clinical features and tumor mutational profile of younger versus older patients with cholangiocarcinoma (CCA).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 240-240
Author(s):  
Lipika Goyal ◽  
Stephanie Reyes ◽  
Apurva Jain ◽  
Rachna T. Shroff ◽  
Tri Minh Le ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Patients ◽  
Tertiary Care ◽  
Tumor Biology ◽  
Young Patients ◽  
Molecular Testing ◽  
Extrahepatic Cholangiocarcinoma ◽  
Younger Patients ◽  
Molecular Features ◽  
Significant Difference

240 Background: As seen in lung cancer, young patients with cancer can have different risk factors, presentation, and tumor genotype than older patients with the same disease. The clinical and molecular features of young patients with CCA have yet to be well characterized. Methods: Retrospective chart review was performed on patients with intrahepatic (ICC) or extrahepatic cholangiocarcinoma (ECC) across 5 institutions. Data on demographics, risk factors, treatments, pathology, and overall survival (OS) were collected. Tumor genotyping results from MGH SNaPShot and Foundation Medicine were analyzed. Log-rank tests and Kaplan-Meier survival curves were used for statistical analysis. Results: Of 567 patients analyzed, 134 (23.6%) were < 50 years old (yo) and 455 (80.2%) had ICC. When assessed for risk factors, younger patients ( < 50yo) were more likely to have primary sclerosing cholangitis (PSC) (p < 0.001) and less likely to have diabetes (p = 0.05), compared to older patients ( ≥ 50yo). Surgical resection rates were similar in younger vs older patients (41.9 vs 42.6%, p = 0.890), but younger patients had larger tumors (median size 7.1 vs 5.3cm p = 0.012). Younger patients were also more likely to receive palliative systemic chemotherapy (p < 0.001) and more lines of therapy (median, 2 vs 1 line, p < 0.001). Frequency of treatment with liver directed therapy did not differ between the two groups. Molecular testing was performed on 222/567 (39.1%) patients of which 84/134 (62.7%) were younger patients and 138/433 (31.9%) were older patients. FGFR aberrations were more common in younger patients versus older patients (17.6 vs. 5.7%, p = 0.002). Targeted therapy was given to 15/84 (17.9%) younger and 28/138 (20.3%) older patients based on results of mutational profiling. Finally, no significant difference was seen in OS between younger and older patients (22.9 vs 22.7 months, p = 0.89). Conclusions: Younger patients with CCA may have different risk factors, tumor biology, and tolerance of systemic therapy compared to older patients. Further study is needed as referral patterns to tertiary care centers and motivation of younger patients to seek tertiary care may impact these results.

scholarly journals Characteristics and outcomes of young patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: retrospective analysis in a multiethnic Asian population

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001437
Author(s):  
Benjamin WL Tung ◽  
Zhe Yan Ng ◽  
William Kristanto ◽  
Kalyar Win Saw ◽  
Siew-Pang Chan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Patients ◽  
Young Patients ◽  
Coronary Intervention ◽  
Younger Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
History Of

ObjectiveST segment elevation myocardial infarction (STEMI) is associated with significant mortality leading to loss of productive life years, especially in younger patients. This study aims to compare the characteristics and outcomes of young versus older patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) to help focus public health efforts in STEMI prevention.MethodsData from the Coronary Care Unit database of the National University Hospital, Singapore from July 2015 to June 2019 were reviewed. Patients were divided into young (<50 years old) or older (≥50 years old) groups.ResultsOf the 1818 consecutive patients with STEMI who underwent PPCI, 465 (25.6%) were <50 years old. Young compared with older patients were more likely to be male, current smokers, of Indian ethnicity, have family history of ischaemic heart disease (IHD) and had lower 1 year mortality (3.4% vs 10.4%, p<0.0001). Although diabetes, hypertension or dyslipidaemia was less common among young patients, the prevalence of having any one of these risk factors was high in the range of 28% to 38%. Age was an independent predictor of mortality in the older but not younger patients with STEMI, and diabetes showed a trend towards mortality in both groups.ConclusionYoung patients with STEMI are more often smokers, of Indian ethnicity and had family history of IHD, although cardiometabolic risk factors are also prevalent. Mortality is lower, but not negligible, among the young patients with STEMI. Public health efforts are needed to reduce the prevalence of these risk factors among the constitutionally susceptible population.

Study on Risk Factors and Pattern of Coronary Artery Involvement in Young Acute Coronary Syndrome Patients

2017 ◽  
Vol 32 (1) ◽  
pp. 40-44
Author(s):  
Tanveer Ahmad ◽  
Muhammad Badrul Alam ◽  
Amiruzzaman Khan ◽  
AKM Monwarul Islam ◽  
Zakir Hossain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Positive Family History ◽  
Young Patients ◽  
Younger Patients ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Coronary Artery Involvement ◽  
Triple Vessel Disease

Aims: To compare the risk factors and pattern of coronary artery involvement in young acute coronary syndrome patients with that of the elderly.Methods: This was a cross sectional analytic study done in the Department of Cardiology, Sir Salimullah Medical College and Mitford Hospital during November 2015 to October 2016.Results: Study population was divided into two subgroups, those 18-40 years were considered as young and those >40 years were considered as elderly. Young patients had greater prevalence of smoking, dyslipidemia and positive family history of Ischemic Heart Disease (IHD), whereas hypertension was more prevalent in the elderly. Younger patients mainly presented with STEMI and predominantly had single vessel disease (SVD), whereas elderly patients frequently presented with NSTEMI and Unstable angina and had higher incidence of double vessel disease (DVD) and triple vessel disease (TVD).Conclusion: Younger patients had a different pattern of risk factors and coronary artery involvement in comparision to the elderly.Bangladesh Heart Journal 2017; 32(1) : 40-44

scholarly journals Effect of Serum Homocysteine on Coronary Artery Disease in Younger and Older Ischaemic Heart Disease Patients

2016 ◽  
Vol 8 (2) ◽  
pp. 138-142
Author(s):  
Kazi Nazrul Islam ◽  
Abdul Wadud Chowdhury ◽  
Azizul Hasan Khondoker ◽  
Md Serajul Haque ◽  
KMN Sabah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Homocysteine Level ◽  
Serum Homocysteine ◽  
Artery Disease

Background: Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis. But the probable role of Hyperhomocysteinemia in Premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of serum homocysteine on angiographically documented CAD in younger and older ischaemic heart disease (IHD) patients.Methods: Total 120 patients with IHD admitted in the Department of Cardiology, Dhaka Medical College Hospital for CAG were selected by purposive sampling method and divided into two groups. 60 patients in Group-I, d” 40 years of age (Younger); 60 patients in Group-II, >40 years of age (Older). Homocysteine was measured in all patients and other demographical and clinical data were collected. Homocysteine level was correlated with the presence and severity of CAD.Results: Smoking, positive family history of IHD, dyslipidaemia and hyper homocysteinemia were important risk factors in younger IHD patients. Whereas, hypertension, diabetes mellitus and dyslipidaemia were important cardiovascular risk factors in older age group. Obesity was not an important risk factors as evidenced by mean BMI. Serum homocysteine was not well related to presence of CAD or extent of CAD in older IHD patients. However in younger patients hyperhomocysteinemia was related to both presence and severity of CAD.Conclusion: In younger IHD patients hyperhomocysteinemia is an important cardiovascular risk factor. But in older patients it loses its significance. So serum homocysteine level should be screened routinely in younger IHD patients.Cardiovasc. j. 2016; 8(2): 138-142

scholarly journals Comparison of coronary risk factors and angiographic findings in younger and older patients with significant coronary artery disease

2018 ◽  
Vol 56 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Mohammad Parsa Mahjoob ◽  
Soheila Sadeghi ◽  
Hamide Falahaty Khanaman ◽  
Mohammadreza Naderian ◽  
Isa Khaheshi
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Older Patients ◽  
Laboratory Data ◽  
Young Patients ◽  
Vessel Disease ◽  
Artery Disease ◽  
Angiographic Findings

Abstract Background. Coronary artery disease (CAD) is uncommon among young adults and may have certain characteristics that are different from those in older patients. The aim of the current study was to determine the risk factors of CAD, important laboratory data and angiographic findings in young patients with CAD and to compare them with the old patients. Methods. Patients with typical chest pain whose CAD was confirmed by coronary angiography were included in the study. These patients were divided into 2 groups: ≥ 45 and < 45 years old; the risk factors of CAD and angiographic findings were determined in each group and further compared. Results. Finally, 231 patients with CAD were included in the study. Thirty-five (30.4%) of patients younger than 45 years and 58 (50.0%) aged ≥ 45 had diabetes mellitus (P = 0.002). Statistically remarkable differences were observed between the two groups regarding hypertension (P < 0.001), myocardial infarction (P < 0.001), Gensini score Median (P < 0.001), ejection fraction in echocardiography (P < 0.001) and fasting blood sugar in laboratory data (P = 0.006). The older group, compared with the younger one, had higher left anterior descending (LAD) artery (P < 0.001), right coronary artery (RCA) (P < 0.001), 3 vessel disease (P < 0.001) and 2-vessel disease (P = 0.044); on the other hand, 1-vessel disease was higher in patients aged < 45(P < 0.001). Conclusion. The risk profile and angiographic findings are different in young patients with CAD compared to older patients. Young patients with CAD tend to be male with a positive familial history, but with less diabetes or hypertension. The older patients had higher 3 vessel disease, 2-vessel disease and left anterior descending (LAD) artery and right coronary artery (RCA) involvements. In contrast, 1-vessel disease was higher in young patients aged <45.

Characteristics, outcomes, and risk factors of ICANS after axicabtagene ciloleucel: Does age matter?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Patients ◽  
Clinical Course ◽  
International Prognostic Index ◽  
Age Groups ◽  
Central Nervous System Involvement ◽  
Microvascular Disease ◽  
B Cell Lymphoma ◽  
Younger Patients

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

Abstract TMP19: Intravenous Recombinant Tissue-type Plasminogen Activator Use in Young Adults With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jodi A Dodds ◽  
Ying Xian ◽  
Shubin Sheng ◽  
Gregg Fonarow ◽  
Ronald A Matsouaka ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Older Patients ◽  
Young Patients ◽  
Tissue Type ◽  
Stroke Patients ◽  
Younger Patients ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator

Background: Intravenous recombinant tissue-type plasminogen activator (rt-PA) administration improves outcomes in acute ischemic stroke. However, young patients (<40 years old) presenting with stroke symptoms may experience delays in treatment due to misdiagnosis or a reluctance to treat since they do not fit the profile of a typical stroke patient. Methods: We analyzed data from the large national Get With The Guidelines–Stroke registry for acute ischemic stroke patients hospitalized between January 2009 and September 2015. Multivariable models with generalized estimating equations (GEE) were used to test for differences between younger (age 18-40) and older (age > 40) acute ischemic stroke patients, controlling for patient and hospital characteristics including stroke severity. Results: Of 1,320,965 AIS patients admitted to participating hospitals, 2.3% (30,448) were aged 18-40. Among these patients, 12.5% received rt-PA versus 8.8% of those aged >40 (p<0.001). Of patients arriving within 3.5 hours of symptom onset without contraindications, 68.7% of younger patients received IV rt-PA versus 63.3% of older patients (adjusted OR [aOR] 1.30, 95% CI 1.21 to 1.40), without evidence that age-related differences varied by sex (interaction p-value 0.25). Odds ratios of achieving target door-to-CT times and door-to-needle (DTN) times, and outcomes of rtPA-treated patients, are shown in the Table. Conclusions: Young acute ischemic stroke patients did not receive rt-PA treatment at lower rates than older patients. Outcomes were better and the rate of symptomatic intracranial hemorrhage was lower in the young patients. However, younger patients had significantly longer door-to-CT and DTN times, providing an opportunity to improve the care of these patients.

Abstract 14178: Characteristics and Outcomes of Young ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Benjamin W Tung ◽  
Zhe Yan Ng ◽  
William Kristanto ◽  
Kalyar W Saw ◽  
winnie C sia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Older Patients ◽  
Young Patients ◽  
Percutaneous Intervention ◽  
Old Patients ◽  
Younger Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Primary Percutaneous Intervention

Introduction: ST-segment elevation myocardial infarction (STEMI) is associated with significant morbidity and mortality leading to loss of productivity and productive life years, especially in younger patients. Understanding the characteristics of younger patients with STEMI and their outcomes could help focus public health efforts in STEMI prevention within a population. Aim: This study aims to compare the characteristics and outcomes of younger versus older patients with STEMI undergoing primary percutaneous intervention (PPCI). Methods: Data from the Coronary Care Unit database of the National University Hospital between July 2015 to June 2019 was reviewed. Patients were divided into Young (<50 years old) or Old (≥50 years old) groups. Results: Of the 1818 consecutive patients with STEMI and underwent PPCI, 465 (25.6%) were Young patients with mean age 43±4.9 years old as compared to Old patients with mean age 63.2±9.4 years old. Young patients were more likely to be male (94% vs. 85%, p<0.0001), current smokers (61.1% vs. 42.6%, p<0.0001), of Indian ethnicity (32% vs. 16.3%, p<0.0001), and had family history of myocardial infarction (MI) (18.1% vs. 9.5%, p<0.0001). Compared to Old patients, Young patients had better post-MI left ventricular ejection fraction (49.5±10.7 vs. 47.8±11.6, p=0.007) with fewer of them suffered from cardiogenic shock (7.1% vs. 13.2%, p<0.0001), and had lower mortality at one year (3.4% vs. 10.4%, p<0.0001). Although diabetes, hypertension and hyperlipidemia was less common among the Young patients when compared to the Old, the prevalence was high in the range of 28 to 38% (Table 1). Conclusions: A sizable proportion of STEMI patients are younger than 50 years old. The risk profile of these younger patients can be attributed to constitutional factors and smoking but other cardiovascular risk factors are also prevalent among them. Although mortality is lower among the younger than the older patients, it is not negligible.

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