30岁以下吸毒人群急性心肌梗死患者的临床和冠状动脉病变特点

目的:研究30岁以下吸毒人群急性心肌梗死(AMI)患者的临床和冠状动脉病变特征。方法:回顾性分析2007年6月至2012年6月,武警广东总队医院司法病区中心收治的50例经冠状动脉造影确诊AMI患者。结果:50例患者中48例为急性ST段抬高型心肌梗死(STEMI),2例为急性非ST段抬高型心急梗死(NSTEMI);无论男女,随吸毒合并的危险因素的增加,AMI的发生率升高。冠状动脉造影资料结果分析发现:不同吸毒时间的AMI患者,多为单支病变,比例明显高于三支病变和主干病变,其中血管以左前降支病变为最常见病变,其次为右冠状动脉、回旋支。三支及主干病变在吸毒时间<5年患者中未见,随吸毒时间延长,三支及主干病变增加。50例患者中8例吸毒时间<5年为非阻塞性病变,42例进行了经皮再血管化治疗。随访期间有1例在监押场所猝死。2例因心绞痛发作再住院。结论:30岁以下吸毒人群AMI患者多为急性STEMI,以单支、阻塞性病变多见,吸毒时间<5年为非阻塞性病变,前降支为最常见的罪犯血管,吸毒时间越长,合并危险因素越多,AMI的发生率越高。短期预后大部分患者较好。

Clinical Features and Coronary Characteristics of Acute Myocardial Infarction in Young Drug Abuse Patients

Objective:To study clinical and coronary characteristics of acute myocardial infarction (AMI) in young drug abuse patients(<30 years old).Methods:Data of 50 consecutive patients referred to our department from June 2007 to June 2012,diagnosed as acute myocardial infarction and underwent emergent coronary angiography were analyzed.Results:Of the 50 patients,48 cases were ST-segment elevated myocardial infarction(STEMI),and 2 cases were non-ST-segment elevated myocardial infarction.No matter which gender,the rate of AMI was increased according to the increasing of risk factors.Single vessel lesion was the most common type in these AMI patients with different drug abuse time,and the rate was significantly higher than that of three vessels and main stem stenosis.The most common culprit vessel was the left anterior descending artery, and secondly was the right coronary artery and left circumflex artery lesion.Three vessels and main stem lesion were seldom occurred in patients of drug abuse time <5 years,and with drug abuse time prolonging,three vessel and main stem lesion became more.Eight cases of 50 patients were non-obstructive lesion,while 42 underwent percutaneous coronary intervention.There was one death in imprisonment court and 2 re-occurred for angina during the follow-up.Conclusion:Most AMI in young drug abuse patients(<30 years) with acute myocardial infarction was STEMI.Single vessel and obstructive lesion was the most common type.Non-obstructive lesion was common in patients of drug abuse time <5 years.The most common culprit vessel was the left anterior descending artery. With drug abuse time prolonging and drug-abuse risk factors increasing,the rate of AMI was increasing.Most patients in this study showed good short-term prognosis.