Coronary Artery DiseaseComparison of Long-Term Mortality of Patients Aged ≤40 Versus >40 Years With Acute Myocardial Infarction
Section snippets
Methods
This study was conducted according to the Declaration of Helsinki and approved by the institutional review boards of all 6 publicly funded hospitals in Singapore. All patients consecutively hospitalized for MI at the 6 hospitals are captured in this unselected registry that includes 96.0% of patients with MI in Singapore. The public health care system in Singapore provides health care access to all Singapore citizens and permanent residents through 3 interdependent government-led financing
Results
From the study population of 15,151 patients hospitalized for MI, 601 (4.0%) were ≤40 years, whereas 14,550 were >40 years (Table 1). Female was the minority gender in both the ≤40 and >40 age group, although the proportion of women was significantly lower in the ≤40 group. Among the ≤40-year-old patients with MI, the ethnic composition was as follows: 53.7% Chinese, 25.0% Malays, and 21.3% Indian, whereas that in the >40 group was 67.2%, 19.6%, and 13.2% for Chinese, Malay, and Indian,
Discussion
In our study of young patients with MI, age 40 was taken as the cutoff so as to achieve a balanced sensitivity and specificity in selecting biologically young patients. Moreover, age 40 was also one of the most commonly used cutoff in the existing literatures,3, 4, 5, 6, 7, 17 thus applying this same cutoff would allow comparisons with existing data. Among our Asian cohort of patients hospitalized for MI from 2000 to 2005, patients ≤40 years were uncommon with a prevalence of 4.0%. This is
Acknowledgment
The authors would like to acknowledge the efforts of all the clinical research co-ordinators from the Singapore Cardiac Databank, Singapore. They would also like to acknowledge Sandra Lim (National Registry of Diseases office) for linking data from the Singapore Cardiac Databank with mortality outcomes from the Singapore Births and Deaths Registry.
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Drs Chua and Chan are co-senior authors.
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