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Research Article | Volume 14 Issue: 3 (May-Jun, 2024) | Pages 49 - 53
A Case-Control Study on Modifiable Risk Factors in Young Myocardial Infarction Patients
 ,
 ,
 ,
1
Consultant Cardiologist, Mavjat Hospital, Palanpur, Gujarat, India
2
Tutor, Department of Endocrinology, TNMC and BYL Nair Charitable Hospital Mumbai, Maharashtra, India
3
Assistant Professor, Department of General Surgery, Banas Medical College and Research Institute, palanpur, Gujarat, India
4
Associate Professor, Department of Physiology, NAMO Medical Education and Research Institute, Silvassa, UT of DNH and DD, India
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Abstract

Introduction: Cardiovascular disease is a significant global health issue. Cardiovascular disease is a major contributor to mortality and morbidity in India. This study investigated the characteristics and risk factors of patients admitted for myocardial infarction (MI). Enhancing comprehension of the risk factors will enable us to plan more effective techniques for mitigating heart disease. Material and Methods: A total of 100 patients were included, with 65% being male and 35% female. The majority of patients (80%) within the middle-aged adult category (30-40 years old). This study involved the analysis of young patients suffering from myocardial infarction. The inclusion criterion includes the male and female in the age group of 20 years to 40 years. The exclusion criterion included the patients suffering from some other cardiac disease. The outcome consists of the analysis of the various factors involved in the occurrence of myocardial infarction in young patients. Results: Results showed significant differences in risk factors between genders. Hypertension was more prevalent in males (21.54%) compared to females (8.57%), while smoking was more common in females (65.71%) than males (44.62%) among studied patients. Both these differences were statistically significant (p-value < 0.05). Diabetes mellitus was also more common in males (15.38%) than females (8.57%), and this difference was statistically significant (p-value < 0.05). Tobacco chewing was less frequent than smoking but still showed a statistically significant difference between genders (p-value < 0.05), with a higher prevalence in males (10.77%) compared to females (2.86%). In terms of the type of myocardial infarction, the anterior wall was more affected compared to the lateral wall. STEMI (ST-segment elevation myocardial infarction) was less frequent than NSTEMI (Non-ST-segment elevation myocardial infarction) for both the anterior and lateral walls. Conclusion: A substantial portion of cases was classified as "Other or Unspecified" due to limitations in identifying the precise location of the infarction. This study highlights the importance of considering gender differences in risk factors for MI. While smoking was the most prevalent risk factor overall, it was significantly higher in females. Further research is warranted to understand the reasons behind these gender variations and improve preventative strategies.

Keywords
INTRODUCTION

Cardiovascular disease is the leading cause of mortality globally [1]. One significant factor contributing to heart disease is the obstruction of arteries [2]. This research examined many factors that potentially increase the susceptibility to heart disease [2]. Several factors that might elevate this risk include diabetes, hypertension, hyperlipidemia, tobacco use, excessive alcohol consumption, obesity, and insufficient physical activity [3, 4]. Additional variables that may have an impact include the distribution of body fat, dietary habits, stress levels, feelings of loneliness, and social isolation [5, 6].

 

Additionally, blood testing may provide indications of heightened risk [7, 8, 9]. Nevertheless, these risk variables may differ according to geographical location [10, 11]. Smoking is a significant risk factor in India and several Arab countries [10, 11]. According to recent research, individuals of African heritage had a reduced genetic predisposition to heart disease [12]. Individuals of Indian descent in Trinidad are believed to have an increased susceptibility [13, 14]. This research conducted a comparison of risk variables between those who had a heart attack and those who did not. The participants in the study were paired based on their age and gender [13,14].

 

Cardiovascular disease is a significant global health issue. Cardiovascular disease is a major contributor to mortality and morbidity in India. Myocardial infarction, also known as a heart attack, is the most prevalent form of heart disease [15]. Males have a higher propensity for experiencing myocardial infarctions compared to females. Heart disease is projected to become the primary cause of mortality worldwide by the year 2020 [15]. The prevalence of risk factors associated with heart disease is on the rise. The prevalence of diabetes is increasing globally. Tobacco use is a significant contributing factor to the development of cardiovascular disease and is increasing in prevalence among the younger population [15]. Obesity is a contributing cause of heart disease and is on the rise among both adults and children. Prevention of heart disease is possible. Enhancing our comprehension of the risk variables will enable us to devise more effective techniques for mitigating heart disease. Modifiable risk factors, such as dietary habits and physical activity, may be altered to reduce the likelihood of developing heart disease [15].

MATERIALS AND METHODS

This study focused on young adults (20-40 years old) who experienced myocardial infarction (heart attack). It specifically looked at male and female in this age group mentioned, excluding those with other pre-existing heart conditions. The goal outcome measure was to identify the various factors contributing to heart attacks in this younger population. Statistical analysis was used to analyze the p-values.

RESULTS

TABLE 1: Male and Female patients

Gender

n

Percentage (%)

Male

65

65.00

Female

35

35.00

 

TABLE 1 displays the gender distribution of patients in research. The patient population consists of 100 individuals, with 65 being male (65.00%) and 35 being female (35.00%). From this data, we may derive two primary observations: The male gender constitutes the bulk of the patients in this research. Although females constitute a minority in this research, they nonetheless account for a substantial proportion (35%) of the patients.

 

TABLE 2: Age demography analysis

Age

n

Percentage (%)

20-30 years

20

20.00

30-40 years

80

80.00

 

TABLE 2 displays the demographic breakdown of patients' ages in a research study. Below is an analysis of the discoveries: Individuals between the ages of 20 and 30, namely younger adults, make up a total of 20 patients, which corresponds to 20.00% of the overall population. Middle-aged adults, aged between 30 and 40 years old, are the largest age group, accounting for 80.00% of the total with 80 cases. The bulk of the patients included in this research belong to the middle-aged adult category, namely, between the ages of 30 and 40.

TABLE 3: Risk factors analysis

Risk factors

Male n (%)

Female n (%)

Total n (%)

p-value

Hypertension

14 (21.54)

3 (8.57)

17 (22.31)

0.015

Smoking

29 (44.62)

23 (65.71)

52 (43.16)

0.005

Tobacco chewing

7 (10.77)

1 (2.86)

8 (10.53)

0.023

Diabetes mellitus

10 (15.38)

3 (8.57)

13 (17.11)

0.002

 

TABLE 3 displays the frequency of several risk factors for cardiovascular disease (CVD) among the participants of the research, categorized by gender. Below is a thorough examination of the discoveries: Hypertension, often known as high blood pressure, poses a substantial risk for both males (21.54%) and women (8.57%) in the research. This difference is statistically significant, as shown by a p-value of 0.015. In all, 17.00% of the individuals exhibited hypertension. Smoking is the dominant risk factor, with a much more significant impact on females (65.71%) compared to men (44.62%) in the research.

 

The p-value of 0.005 shows a statistically significant disparity between genders. In all, 52.00% of the participants were smokers. Tobacco chewing, a less prevalent practice compared to smoking, affected 10.77% of men and 2.86% of females. There is a notable and meaningful difference (p-value = 0.023) between the genders, as shown by statistical analysis. In total, 8.00% of the participants said that they engage in the habit of tobacco chewing. Diabetes Mellitus: The prevalence of this ailment was 15.38% among males and 8.57% among females. The disparity between genders is statistically significant, with a p-value of 0.002. In all, 13.00% of the subjects were diagnosed with diabetes mellitus.

Fig.1: Bar graph of the risk factor analysis

 

TABLE 4: Shows the different types of myocardial infarction in patients admitted to a hospital setting

Type of Myocardial Infarction

Estimated Percentage (N=100)

Anterior Wall

 

STEMI (Anterior)

10%

NSTEMI (Anterior)

30%

Lateral Wall

 

STEMI (Lateral)

5%

NSTEMI (Lateral)

20%

Other or Unspecified

35%

 

TABLE 4 distinguishes between myocardial infarctions that impact the front (anterior) wall and the side (lateral) wall of the heart. Distribution: STEMI, which stands for ST-segment elevation myocardial infarction, is often less prevalent compared to NSTEMI, which stands for Non-ST-segment elevation myocardial infarction. Infarction is more often seen in the anterior wall than in the lateral wall. A further classification called "Other or Unspecified" has been added to accommodate instances that involve heart walls other than the ones mentioned or situations where the exact location is unknown. This group includes 35% of patients, recognizing the constraints in determining the area for all instances.

DISCUSSION

When compared to males, women are more likely to have a heart attack due to variables such as high blood pressure, diabetes, and having gone through menopause in the past. When it comes to women, smoking may also be a more significant risk factor [16, 18, 25]. The most important discovery is that our research, along with previous studies, discovered substantial disparities in the ways in which established risk variables impact men and women [16, 17, 26, 27]. The findings of our research indicate that males are more prone to suffer from heart attacks than women owing to factors such as obesity, high cholesterol, and stress. There are a number of possible causes for this phenomenon, including hormonal variations and the impact of smoking on the bodies of women [16, 18]. In addition, the influence of diabetes on the likelihood of having a heart attack varies depending on gender [19, 20, 21]. Stress is probably a risk factor for both men and women [22], despite the fact that our research did not establish a direct connection between the two. Additionally, the impact of cholesterol on the risk of having a heart attack may be more pronounced in males than it is in women [23, 24, 28]. On average, women have their first heart attack around nine years later than males, regardless of geographical location. Nine variables may be controlled, and they have a significant impact on the risk of heart attacks in both men and women worldwide [29]. Both genders are equally affected by similar risk factors for heart attacks, such as cholesterol levels, smoking, abdominal obesity, dietary habits, and stress levels [29]. However, the way in which these variables affect the risk of heart attack varies between men and women in relation to blood pressure, diabetes, exercise, alcohol use, and former smoking habits. The strength of these relationships tends to be more pronounced in younger individuals, regardless of gender [29]. Men are more prone to have heart attacks at a younger age due to the presence of more unfavourable risk factors, such as high cholesterol levels and smoking habits, before reaching the age of 60. This study corroborates previous research that has shown comparable factors contributing to heart disease in both males and females [29]. Nevertheless, this research offers novel perspectives since it takes into account other variables, such as abdominal fat and a broader range of participants [29].

 

CONCLUSION

Our study revealed surprising trends in risk factors for heart attack between males and females. Although smoking was the most common culprit overall, it was significantly more prevalent in females. Conversely, males were more susceptible to hypertension and diabetes. Interestingly, the risk for both genders increased with middle age. These findings highlight the critical importance of incorporating gender-specific factors into preventative strategies for heart attacks.

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