None listed
Conditions
Brief summary
Myocardial infarction (MI) affects ~57,000 Australians every year and almost half a million Australians have had a heart attack at some point in their lives. While mortality after MI has been declining over the last few decades, it is in the group of young patients that it has lagged. Data on the biological and pathophysiological factors related to MI in the young is scarce. In addition, there are gaps in quality of care due to the perceived risk for MI being low. The study aims to characterise the clinical presentation, risk factors, angiography findings, underlying aetiology, quality of care and sex differences, of young patients with MI (age <50 years). This is an investigator-initiated, observational, single-centre clinical registry study. Approximately 500 patients under the age of 50 years with MI will be recruited retrospectively from Westmead Hospital.
Interventions
This is an investigator-initiated, observational, single-centre clinical registry study of young patients with myocardial infarction. At Westmead hospital, it is estimated (based on experience of the principal investigator) that every year, about 40 - 50 patients with Myocardial Infarction (MI) are 18-50 years of age. Therefore, from 2010 until now, approximately 500 patients with MI between 18-50 years can be recruited retrospectively (historical cases, no patient contact or ongoing follow up).
This is an investigator-initiated, observational, single-centre clinical registry study of young patients with myocardial infarction. At Westmead hospital, it is estimated (based on experience of the principal investigator) that every year, about 40 - 50 patients with Myocardial Infarction (MI) are 18-50 years of age. Therefore, from 2010 until now, approximately 500 patients with MI between 18-50 years can be recruited retrospectively (historical cases, no patient contact or ongoing follow up). Patients will be recruited via the medical records at Westmead Hospital. Patients will be recruited with their baseline clinical data entered locally by a study coordinator, into an online centralised database. Baseline data includes background medical history, cardiovascular risk factors (traditional e.g., smoking, diabetes, family history / non-traditional e.g., pre-eclampsia, chronic inflammatory conditions, premature menopause), medications at baseline and on discharge, presentation, triggers, investigations (including multimodality imaging, coronary angiography, echocardiogram), management (including revascularisation) and in-hospital outcomes. Available in-hospital pathology results that have already been performed as part of standard care, including serum creatinine and electrolytes, liver function, full blood count, high sensitivity C-reactive protein (hs-CRP), fasting lipids (TC, LDL, HDL, triglycerides) and diabetic profiles will be collected for all patients. All patients aged 18-50 years, with a diagnosis of MI, who have undergone coronary angiography will be screened for with the help of the medical record department of Westmead hospital. A study coordinator will assess the patient’s medical records for eligibility criteria and confirm with the study investigator. A waiver of consent will be used for patients recruited retrospectively in accordance with the National Statement on Ethical Conduct in Human Research (2.3.10). All data will be collected in a de-identified manner and last date of follow up or death taken from available medical records. Historical patients will be collected in a retrospective manner from 2010 to current study date (i.e., the last 12 years). Retrospectively recruited patients will not have ongoing follow up, Any data available at the time of recuritment will be collected with the date of last follow up or death taken from the available medical records. Participants will not be followed up.
Sponsors
Western Sydney Local Health District
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients aged =>18 years and <=50 years old with acute myocardial infarction (MI) 2. Patients aged >50 years and with acute myocardial infarction (MI) (control group) 2. Type 1 and Type 2 MI are both included, with MI defined according to the 4th universal definition: clinical evidence of acute myocardial ischaemia and detection of a rise and/or fall of cTroponin values with at least 1 value above the 99th percentile upper reference limit and, at least one of the following: a. Symptoms of myocardial ischaemia; b. New ischaemic ECG changes; c. Development of pathological Q waves; d. Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischaemic aetiology; e. Identification of a coronary thrombus by angiography or autopsy 3. Participants must have undergone coronary angiography
Exclusion criteria
# Rise in cardiac biomarkers and/or ECG changes due to a clear non-coronary artery pathology e.g. myocarditis, acute arrhythmia, cardiomyopathy, acute pulmonary embolism (PE), stroke, recent cardiac surgery (these can all cause ischaemic changes on the ECG and/or troponin rises) #Patients with presumed MI who die before the diagnosis has been confirmed by troponin values or coronary angiography (Type 3 MI) #Percutaneous coronary intervention (PCI)-related MI (Type 4 MI) #Coronary artery bypass grafting (CABG)-related MI (Type 5 MI)
Outcome results
None listed