Objective: To observe the characteristics and trends during the last 11 years of risk factors of young adults with first acute coronary syndrome (ACS). Methods: It was a cross-sectional study. We included young adults (18 to 44 years old) hospitalized for acute coronary syndrome in Beijing Anzhen Hospital for a first time from January 2007 to December 2017. Acute coronary syndromes include ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA). The general information, medical history and laboratory test were recorded. Risk factors of ACS were smoking, dyslipidemia, overweight/obesity, hypertension and diabetes. Results: Data from 7 106 patients were analyzed, mean age was (39.8±4.2) years old and 6 593(92.8%)were men, including 2 254 (31.7%) STEMI, 704 (9.9%) NSTEMI and 4 148 (58.4%) UA. Most patients were male (6 593(92.8%)). Dyslipidemia (85.8%(6 094/7 106)), overweight/obesity (82.3%(5 850/7 106)), and smoking (63.9%(4 545/7 106)) were most prevalent. 98.3% (6 885/7 106) patients had at least 1 risk factor. The prevalence of hypertension, diabetes and overweight/obesity increased from 2007 to 2017. Rates of hypertension increased from 37.1%(111/299) to 48.1%(498/1 035) (Ptrend<0.01), diabetes from 12.0%(36/299) to 19.4%(201/1 035) (Ptrend<0.01), overweight/obesity from 74.2%(222/299) to 83.9%(868/1 035) (Ptrend<0.05), respectively. Conclusions: Dyslipidemia, overweight/obesity and smoking are most prevalent risk factors in young adults with a first ACS and most patients have at least 1 risk factor for ACS. Rates of hypertension, diabetes and overweight/obesity progressively increases over time in this patient cohort.
目的: 分析青年初发急性冠状动脉综合征(ACS)住院患者危险因素的分布特点及11年间的变化趋势。 方法: 该研究为横断面调查。入选2007年1月至2017年12月北京安贞医院首次诊断为急性ST段抬高型心肌梗死(STEMI)、急性非ST段抬高型心肌梗死(NSTEMI)以及不稳定性心绞痛(UA)的18~44岁的住院患者。通过电子病历系统收集患者的基本信息、病史及实验室检查结果。ACS危险因素包括吸烟、血脂异常、超重/肥胖、高血压和糖尿病。 结果: 研究共入选患者7 106例,年龄(39.8±4.2)岁,其中男性6 593例(92.8%),包括STEMI患者 2 254例(31.7%)、NSTEMI患者 704例(9.9%)和UA患者 4 148例(58.4%)。ACS的危险因素中,患病比率最高的3个因素依次为血脂异常[85.8%(6 094/7 106)]、超重/肥胖[82.3%(5 850/7 106)]和吸烟[63.9%(4 545/7 106)]。入选患者中≥1个危险因素的比率为98.3%(6 885/7 106)。2007年至2017年11年间,患者高血压、糖尿病和超重/肥胖患病比率呈上升趋势,高血压从37.1%(111/299)上升到48.1%(498/1 035)(P趋势<0.01),糖尿病从12.0%(36/299)上升到19.4%(201/1 035)(P趋势<0.01),超重/肥胖从74.2%(222/299)上升到83.9%(868/1 035)(P趋势<0.05)。 结论: 血脂异常、超重/肥胖和吸烟是青年初发ACS患者最主要的危险因素,大多数患者具有1个及以上危险因素。11年间青年初发ACS患者高血压、糖尿病和超重/肥胖患病比率呈上升趋势。.