Korean Journal of Internal Medicine, 2019. 34(5), 1040-1049, DOI: https://doi.org/10.3904/kjim.2018.056

Clinical characteristics and outcomes in acute myocardial infarction patients with versus without any cardiovascular risk factors

Ah-Ra Choi, Myung Ho Jeong;Young Joon Hong;Seok-Joon Sohn;Hyun Yi Kook;Doo Sun Sim;Young Keun Ahn;Ki Hong Lee;Jae Yeong Cho;Young Jo Kim;Myeong Chan Cho;Chong Jin Kim;other Korea Acute Myocardial Infarction Registry Investigators

Abstract

Background/Aims: Although cardiovascular (CV) risk factors are well established,some patients experience acute myocardial infarction (AMI) even without any riskfactors.

Methods: We analyzed total 11,390 patients (63.6 ± 12.6 years old, 8,401 males) withAMI enrolled in Korea Acute Myocardial Infarction Registry-National Instituteof Health from November, 2011 to December, 2015. Patients were divided intotwo groups according to the presence of any CV risk factors (group I, without riskfactors, n = 1,420 [12.5%]; group II, with risk factors, n = 9,970 [87.5%]). In-hospitaloutcomes were defined as in-hospital mortality and complications. One-yearclinical outcomes were defined as the composite of major adverse cardiac events(MACE).

Results: Group I was older (67.3 ± 11.6 years old vs. 63.0 ± 12.7 years old, p < 0.001)and had higher prevalence of female gender (36.2% vs. 24.8%, p < 0.001) than thegroup II. Group I experienced less previous history of angina pectoris (7.0% vs.9.4%, p = 0.003) and the previous history of cerebrovascular accidents (3.4% vs.6.9%, p < 0.001). In-hospital mortality (2.6% vs. 3.0%, p = 0.450) and complications(20.6% vs. 20.0%, p = 0.647) were no differences between the groups. And 1 yearclinical outcomes (5.7% vs. 5.1%, p = 0.337) were no differences between the groups.In multivariate logistic regression analysis, serum creatinine level (hazard ratio,1.35; 95% confidence interval, 1.05 to 1.75; p = 0.021) were independent predictors of1 year MACE in patients without any CV risk factors.

Conclusions: Elderly female patients were prone to develop AMI even without anymodifiable CV risk factors. We suggest that more intensive care is needed in AMIpatients without any CV risk factors who have high serum creatinine levels.

• DOI: https://doi.org/10.3904/kjim.2018.056
• ISBN or ISSN: 1226-3303

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.