| Abstract: |
ntroduction: Ischemic heart disease is the main cause of death in industrialized countries.. Special attention should be paid to risk factors for cardiovascular disease such as smoking, arterial hypertension, diabetes mellitus, overweight and obesity, sedentary habits and unhealthy dietObjectives: Determination of the differences in risk factors, presentations, complications, management and outcome of acute myocardial infarction in young compared to old patients.Subjects and Methods: This study included sixty subjects,were divided into 3 groupsGroup I (Young age): Included twenty patients presented with AMI, they were non-diabetic patients. Their age ranged from 27 to 39 years.Group II (old age): Included twenty patients presented with AMI, they were non diabetic patients. Their age ranged from 61 to 80 years..Group III (Control group): Included twenty subjects, The members of this group looked apparently healthy with normal clinical examination.All subjects of the study were subjected to the following : History taking and complete clinical examination, calculation of BMI ECG Chest X-Ray, complete blood picture, fasting and two hours post- prandial blood glucose, Liver and Kidney function tests, CPK, CKMB, LDH, Lipid profile, quantitative Determination of Fibrinogen & CRP , Homocysteine Assay, Lipid profile.Results: the present study revealed that coronary risk factors including traditional risk factors as smoking(P<0.01), family history (P<0.01) and dyslipidemia(P<0.001), and non traditional coronary risk factor as homocysteine(P<0.001) for young group as compared to old group, chest pain was the most common presentation in AMI in both age groups, but it was significantly higher in young group (90%) compared to old group (60%), as regard complications of AMI; in our study, cardiac failure and cardiogenic shock were more common in the elderly AMI, while arrhythmia was more common at young patients (P <0.05) our study showed that non Q-wave MI occurred in elderly (45%) more than in young patients (15%), while Q-wave MI occurred in young (85%) more than in elderly (55%) [P <0.05] ,elderly AMI patients were less likely to receive thrombolytic therapy compared to the young patients[(63.6% vs. 85.8%) & P <0.05].Conclusion: the prevalence of various modifiable risk factors between the two age groups, hypertension for the elderly population while for the young population, smoking, family history and hyperlipidemia, non traditional risk factors as homocysteine is significantly higher in young MI patients than in old MI patients, and fibrinogen is significantly higher in old MI patients.
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