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62 Cardiovascular disease in young adults: a retrospective analysis of </=45-year-old patients presenting with st elevation myocardial infarction in the United Kingdom
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  1. Velvet-John Anju1,
  2. G Dubey1,
  3. N Malik1,2
  1. 1Manchester Royal Infirmary
  2. 2The University of Manchester

Abstract

Background There is no universal screening program for the risk stratification of younger patients (<40 years), which would enable them to have access to primary prevention of CVD. In UK, current NICE guidelines on primary prevention advocate a review of CVD risk in those >40 years.

Methods The main aim of our retrospective single-centre study was to look at patients </= 45 years presenting with ST- elevation myocardial infarction (STEMI), to identify the burden of risk factors that has gone unrecognized and untreated. We analyzed electronic medical records of patients between March 2019 and 2020. Data included patient characteristics, primary prevention received; revascularisation, Left ventricular (LV) impairment and any major adverse cardiovascular events with a follow-up period of 2 years. Table 1 shows specific risk factor % and table 2 known past medical history.

Results Of 159 patients aged between 22-45 (median 40) years with a STEMI, 81% were males and Caucasians (60%). 67% had a history of smoking, 40% a high BMI and 30% a family history of premature CVD. 35% of study population was diagnosed to have hypercholesterolaemia on admission, but only 0.6% had a known formal diagnosis of hypercholesterolaemia pre-admission. Only 10% were found to be on primary prevention, and these were for disease-specific treatment such as for hypertension and diabetes. Anterior STEMI was 38%, inferior STEMI 31% and 16% presented with out-of-hospital cardiac arrest (OOHCA). 21% had high thrombotic burden requiring Gp2b3a infusion. 40% had PCI to LAD, 21% to RCA, 9% to Left Circumflex, 3% had Coronary Artery Bypass Grafting, 4% managed medically, 20% had bystander disease and 6% were treated with staged PCI. 23% had normal coronaries. Post-procedure echocardiogram LV function was normal in 35%, with borderline LV systolic dysfunction (LVSD) 17%, impaired LVSD 29% and severe LVSD in 19%. No CVA was recorded post-procedure, and death was reported in 5% (8/159) with a median of 19 days post-procedure, out of which 5/8 had presented with an OOHCA.

Conclusion This study demonstrates a considerable burden of risk factors for CVD in a young population who presented with a STEMI, highlighting the need for universal screening, risk stratification, and advise on prevention of CVD in adults below 45 years.

Abstract 62 Table 1

Proportion of risk factors

Abstract 62 Table 2

Proportion of recorded past medical history

Conflict of Interest none

  • Coronary
  • Young
  • Cardiovascular

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