Læknablaðið - 01.01.2017, Síða 15

LÆKNAblaðið 2017/103 15
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ENGLISH SUMMARY
Introduction: While acute myocardial infarction (AMI) mostly is a dise-
ase of the elderly it also affects younger individuals, often with serious
consequenses. In 1980-1984 a study was carried out on the incidence,
risk factors, infarct location and distribution of atherosclerosis among
Icelanders forty years and younger with AMI. Here we present the
results of a similar study carried out for the five year period 2005-2009.
Materials and methods: Medical and autopsy records of all indivi-
duals, forty years and younger, diagnosed with AMI (I21 in ICD-10) at
Landspitali, National University Hospital 2005-2009, or suffering sudden
cardiac death in Iceland during the same period were reviewed. Blood
tests, electrocardiograms, echocardiograms, coronary angiograms and
autopsy results were reviewed with respect to AMI-criteria. Statistical
comparisons of ratios and means were carried out using Chi-square test
and T-test, respectively.
Results: 38 individuals 40 years and younger, 32 males and 6
females, fulfilled the diagnostic criteria of AMI. Calculated incidence for
the population at risk was 10/100.000/year (14/100.000/year in 1980-
1984) and the mean age ±S.D. was 36.7±3.9. Three (7.9%) died suddenly
before reaching hospital but of the 35 hospitalised patients 30 day
mortality was zero, compared to nine (23.7%) pre-hospital deaths and
two (6.9%) hospital deaths in 1980-1984. Thus, combined pre-hospital
and in-hospital (30 day) mortality was 28.9% and 7.9% in the previous
and recent time periods, respectively (p=0.02). In 2005-2009, 77.1%
had a smoking history and 31.4% were hypertensive compared to 97%
and 6.9% in 1980-85 (p=0.026 and p=0.015, respectively). Body mass
index (BMI) was higher in the later period, 28.6±4,8 kg/m2 compared
to 26.1±3.6 (mean±S.D.; p=0.04) but s-cholesterol was lower, 5.1±1.4
mmol/L compared to 6.3±1.16 ( mean±S.D.; p<0.01). In both studies
single coronary artery disease was the most common angiographic
pattern and the left anterior descending artery most often involved.
Conclusion: Our results show that in two surveys 25 years apart AMI
patients 40 years and younger are most often men. Smoking and family
history were the most prominent risk factors during both periods but
hypertension and high BMI were more common in 2005-2009 than in
1980-1984. Prognosis, as indicated by combined pre-hospital and
in-hospital (30 day) mortality has improved.
Acute myocardial infarction among Icelanders forty years old and younger 2005-2009.
Comparison with a study carried out 1980-1984
Björn Jakob Magnússon1, Uggi Agnarsson2, Þórarinn Guðnason2, Guðmundur Þorgeirsson1,2
1Faculty of Medicine University of Iceland, 2National University Hospital, Reykjavík, Iceland.
Key words: Myocardial infarction, forty and younger, incidence, risk factors, mortality, time trend
Correspondence: Guðmundur Þorgeirsson gudmth@landspitali.is