Brátt hjartadrep meðal yngri einstaklinga: rannsókn á nýgengi, áhættuþáttum og horfum

INNGANGUR
Nýgengi bráðs hjartadreps hefur lækkað í almennu þýði á undanförnum áratugum en margt bendir til þess að þetta eigi ekki við um yngstu aldurshópana. Markmið þessarar rannsóknar var að kanna nýgengi, áhættuþætti og horfur eftir brátt hjartadrep meðal ungra einstaklinga hér á landi.

EFNIVIÐUR OG AÐFERÐIR
Rannsóknin var afturskyggn gagnarannsókn. Gögn fengust úr gagnagrunni SCAAR-SWEDEHEART, sjúkraskrám Landspítala og Dánarmeinaskrá landlæknis. Í rannsóknarþýðinu var faraldsfræði milli kvenna ≤55 ára og karla ≤50 ára sem greindust með brátt hjartadrep (STEMI/NSTEMI) á Íslandi á árunum 2014-2020 borin saman við eldri sjúklinga.

NIÐURSTÖÐUR
Af öllum STEMI- og NSTEMI-tilfellum á Íslandi á tímabilinu (2852) voru 344 sjúklingar (12%) ungir. Ekki var sýnt fram á breytingu á nýgengi bráðs hjartadreps meðal yngri aldurshópsins á tímabilinu. Hlutfall STEMI var hærra meðal yngri sjúklinga samanborið við eldri (52% á móti 35%, p30 kg/m2) (47% á móti 36%, p
ÁLYKTANIR
Á rannsóknartímabilinu var ekki sýnt fram á breytingu á nýgengi bráðs hjartadreps meðal yngri einstaklinga. Yngri einstaklingar með brátt hjartadrep hafa aðra áhættuþætti en þeir eldri, þeir hafa lægra dánarhlutfall en sömu líkur á endurteknu hjartadrepi ári eftir áfallið.

INTRODUCTION: The incidence of acute myocardial infarction (AMI) might not be decreasing as much among young adults as in the general population in recent years. The goal of our study was to explore incidence, risk factors and prognosis of AMI among young patients in Iceland.

MATERIAL AND METHODS: This was a retrospective case control study. The data was obtained from the SCAAR-SWEDEHEART database, medical records from Landspitali University Hospital and the death register from the Directorate of Health. The epidemiology of women ≤55 years and men ≤50 years diagnosed with AMI (STEMI/NSTEMI) in Iceland in 2014-2020 was compared with older patients.

RESULTS: Of all the cases (2852), 344 patients (12%) were young. No change was demonstrated in the incidence of AMI in the young patients during the study period. The proportion of STEMI was higher among young patients (52% vs. 35%, p<0.001). Smoking (50% vs. 26%, p<0.001) and obesity (BMI>30 kg/m2)(47% vs. 36%, p<0.01) were more prevalent in younger patiens compared to the older. Older patients were more likely to die in the year following the AMI, both from all-cause (7% vs. 3%, p<0.05) and cardiovascular mortality (7% vs. 3%, p<0.05). A difference in recurrent AMI between the young and older patients was not demonstrated (2% vs. 3%, p=0.3).

CONCLUSION: During the research period, a change in the incidence of AMI among young patients, was not demonstrated. Younger patients with AMI have different risk factors than older patients, they have lower mortality rate but the same risk of recurrent AMI.