TY - JOUR
T1 - Causes, Angiographic Characteristics, and Management of Premature Myocardial Infarction
T2 - JACC State-of-the-Art Review
AU - Rallidis, Loukianos S.
AU - Xenogiannis, Iosif
AU - Brilakis, Emmanouil S.
AU - Bhatt, Deepak L.
N1 - Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/6/21
Y1 - 2022/6/21
N2 - Among patients presenting with acute myocardial infarction (AMI), the proportion of young individuals has increased in recent years. Although coronary atherosclerosis is less extensive in young patients with AMI, with higher prevalence of single-vessel disease and rare left main involvement, the long-term prognosis is not benign. Young patients with AMI with obstructive coronary artery disease have similar risk factors as older patients except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Smoking cessation is by far the most effective secondary preventive measure. Myocardial infarction with nonobstructive coronary arteries is a relatively common clinical entity (10%-20%) among young patients with AMI, with intravascular and cardiac magnetic resonance imaging being key for diagnosis and potentially treatment. Spontaneous coronary artery dissection is a frequent pathogenetic mechanism of AMI among young women, requiring a high degree of suspicion, especially in the peripartum period.
AB - Among patients presenting with acute myocardial infarction (AMI), the proportion of young individuals has increased in recent years. Although coronary atherosclerosis is less extensive in young patients with AMI, with higher prevalence of single-vessel disease and rare left main involvement, the long-term prognosis is not benign. Young patients with AMI with obstructive coronary artery disease have similar risk factors as older patients except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Smoking cessation is by far the most effective secondary preventive measure. Myocardial infarction with nonobstructive coronary arteries is a relatively common clinical entity (10%-20%) among young patients with AMI, with intravascular and cardiac magnetic resonance imaging being key for diagnosis and potentially treatment. Spontaneous coronary artery dissection is a frequent pathogenetic mechanism of AMI among young women, requiring a high degree of suspicion, especially in the peripartum period.
KW - MINOCA
KW - SCAD
KW - cocaine
KW - premature myocardial infarction
KW - smoking
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U2 - 10.1016/j.jacc.2022.04.015
DO - 10.1016/j.jacc.2022.04.015
M3 - Review article
C2 - 35710195
AN - SCOPUS:85131962127
SN - 0735-1097
VL - 79
SP - 2431
EP - 2449
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 24
ER -