Evaluation of thrombophilic and atherosclerotic markers in young patients (<45 years) with st-segment elevated myocardial infarction

Author: 
Rakesh Tumula, Jenny Madhuri Gudivada and Malladi Srinivasarao

Objective: The present study was designed to evaluate the clinical profile, thrombophilic and atherosclerotic markers in young patients with ST-segment elevated myocardial infarction (STEMI).
Methods: This was an observation, hospital-based study which included 46 young (≤45 years)and 46 elderly (≥60 years) patients with STEMI. Electrocardiogram, echocardiogram, carotid intima media thickness (CIMT), ankle-brachial pressure index (ABPI) were assessed. The serum tissue plasminogen antigen (TPA), plasminogen activator inhibitor-1 and antithrombin-III were analyzed and compared with elderly STEMI patients, and then patients are subjected to coronary angiography to know vessel involvement.
Results: Among 46 young patients, 38 (82.6%) were males. Total 65.2%patients were smokers and28 (60%) had dyslipidemia and 17.4% had obesity (17.4%).Chest pain was most common symptom (91%). Mean time to thrombolysis was 41.5min. Among all, 31.7% had normal coronary angiograms and 43.5% patients had single vessel involvement (43.5%). Mean CIMT increased as the severity of coronary artery disease increased. Serum TPA in the young group was statistically significant compared to elderly group (p=0.006).
Conclusion: In young STEMI patients, CIMT and ABPI do not appear to be useful surrogate markers of atherosclerosis unlike elderly patients. Thrombophilia whether inherited or acquired seems to have a role to play in the young STEMI patients however, larger studies are required in further to prove this.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2020.22005.4333
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