CAD risk factors and acute myocardial infarction in Pakistan

Objective - Acute myocardial infarction (AMI) in adult patients under the age of 45 is relatively unusual. Recent studies have shown a higher prevalence of AMI in young South Asian migrants. Data on South Asians in South Asia on cardiovascular disease (CVD) patients is lacking. The purpose of this study is to look at the classical risk factors of coronary artery disease (CAD) in young men and women and their older counterparts who presented to the emergency service of the Aga Khan university hospital (AKUH) and were diagnosed with AMI. Methods - 976 consecutive patients admitted to AKUH with AMI between January 2000-December 2002 were divided into two groups: <45 years (young) and >45 years (old). Demographic factors, clinical symptoms and presence of risk factors for CAD were recorded with the help of pre-tested data extraction forms. Results - Young patients represented 16.1% of all patients with AMI. 93.1% of the young patients were men. Young male patients were more likely to be smokers and have high cholesterol levels as compared to their young female counterparts. Young AMI patients when compared to old AMI patients, were more likely to have hypertension, positive family history of coronary artery disease, high cholesterol, high LDL and high triglycerides. Conclusion - In this study, the risk factor profile between young and old patients and between the two genders was found to be different. Thus adult management protocols for AMI should be different from the ones for older patients and gender difference should also be considered.