Myocardial infarction in the young: An analysis of the risk factors and coronary angiogram.

PURPOSE: To determine the significant risk factor among young Filipinos (less than forty years of age) and correlate the number of risk factors to the number of coronary arteries involved.
PATIENTS AND METHODS: Thirty-three young patients admitted at St. Lukes Medical Center from January, 1993 to October, 1994 diagnosed to have myocardial infarction who subsequently underwent coronary arteriography using transfemoral Seldingers technique were included in study. Risk factors identified the following: (1) smoking, (2) family history of coronary artery disease, (3) diabetes mellitus, (4) hypertension, (5) hypercholesterolemia, (6) hypertriglyceridemia, (7) low HDL, (8) elevated LDL, (9) left ventricular hypertrophy by 2-D echocardiography and/or electrocardiography. Frequency distribution was used to determine presence of variables. Chi-square was used to test the association between one variable and vessel involvement. Multiple regression was then used to test the association between variables and vessel involvement.
RESULTS: Occurrence of myocardial infarction for Filipinos less than 40 years of age were all males. Analysis of the variables show that smoking of at least five cigarettes per day at least a year was the most common and is a significant risk factor (69/7%). In the multiple regression analysis, low HDL plays a major role and is the predictive factor in the development of coronary artery disease (Sig. T=0.0151 with p values 0.05). A single vessel involvement was the most prevalent (51.5%) with the left anterior descending artery as the most frequently involved artery (90%).
CONCLUSION: In Filipinos less than 40 years of age, low HDL is a predictive factor with both smoking and low HDL as a significant risk factors in the development of myocardial infarction, involving mostly the left anterior descending artery.