DOI: https://doi.org/10.53350/pjmhs221651114 ORIGINAL ARTICLE 1114 P J M H S Vol. 16, No. 05, May 2022 Risk Factors Leading to ST Elevation Myocardial Infarction in Young Patients Presenting to a Tertiary Care Hospital, Islamabad Pakistan MUHAMMAD SAID NAWAZ 1 , KALSOOM BIBI 2 , SYED NASIR ALI SHAH 3 , NOUMAN KHAN 4 , MUHAMMAD ILYAS 5 , ZARAK KHAN 6 1 PGR Cardiology PIMS Hospital, Islamabad 2 House Officer, Sir Ganga Ram Hospital, Lahore 3 Associate Professor Cardiology PIMS Hospital, Islamabad 4,5,6 PGR Cardiology PIMS Hospital, Islamabad Corresponding Author: Muhammad Said Nawaz, Email: Nawaz_222@yahoo.com ABSTRACT Objective: To determine the risk factors leading to ST Elevation Myocardial infarction in young patients presenting to a tertiary care hospital,Islamabad Pakistan Methodology: Prospective observational study was conducted at Pakistan Institute of Medical Sciences, Cardiology department, Islamabad, Pakistan for duration of 10 months. Study was conducted on sample size of 164 selected through non-probability consecutive sampling technique. Study included participants with age less than or equals to 45 and participants from both genders.However, participants with Age more than 45and those having non ST myocardial infarction were excluded. findings including Blood pressure, pulse, respiratory rate, cyanosis, S3, Killip class and JVP were noted. Data was entered and analyzed using statistical package for social sciences (SPSS). P value of < 0.05 was considered as significant. Results: Mean age of participant was found to be 25.3±4.3, mean BMI was found to be 25.8 ±0.81. Mean HB level was found to be 12.8±0.8 and mean respiratory rate was found to be 18. Risk factor HTN in association with gender was found to have significant difference between two with p value of 0.01 In study analysis it was seen that risk factor HTN in association with age was found to have significant difference between two with p value of 0.05.Smoking in association with age was found to have shown significant difference between two with p value of 0.02Family history of MI in association with age was found to have shown significant difference between two with p value of 0.04. Conclusion: Risk factors HTN ,Smoking and family history were found to be positively associated with ST elevation myocardial infarctionin young age. INTRODUCTION Onset of angina rapidly progresses to fully evolved myocardial infarction (MI) in young patients. The vast majority of young patients deny history of chest pain prior to MI. 1 Approximately one to two percent of the adult population in developed countries has Heart failure, with the prevalence of more than 10 percent among persons age less than or equal to seventy years of age. However, in younger individual it is also prevalent. It is clear that the incidence rate is going to increase. Early recognition and risk factor modification in this population sub-set is of key importance. These patients have different risk factor profile, presenting sign and symptoms and prognosis. 2 Different socio-economic and environmental conditions may predispose them to increased risk of Myocardial Infarction. Congenital coronary artery anomalies can present for the first time as MI in young adults. Rare condition causing acute coronary artery dissection is found to be prevalent in young adults. The chest pain is often atypical and women are at a higher risk during their peripartum period. Thrombotic occlusion of a coronary artery can result in acute MI 3 . ST-segment elevation MI also commonly known as STEMI is most frequently caused by acute rupture of atherosclerotic plaque and thrombosis of the involved coronary arteries. Diagnosis is made on basis of the ECG showing ST-segment elevation in two consecutive leads with of 0.1 mV or 1 mm. 4 STEMI is the most acute manifestation of coronary artery disease and is associated with great morbidity and mortality. A complete thrombotic occlusion developing from an atherosclerotic plaque in an epicardial coronary vessel is the cause of STEMI in the majority of cases. 5 Early diagnosis and immediate reperfusion are the most effective ways to limit myocardial ischemia and infarct size and thereby reduce the risk of post- STEMI complications and heart failure. 6 Less published literature in young immigrant population regarding ST elevation myocardial infarction in young patients is found. Better prognosis among young adults was achieved when the appropriate investigations and treatment was offered. This information provides guidance to physicians for better identifying and targeting primary and secondary preventative treatment options. METHODOLOGY Prospective observational study was conducted atPakistan Institute of Medical Sciences, Cardiology department, Islamabad, Pakistan for duration of 10 months. Study was conducted on sample size of 164 selected through non-probability consecutive sampling technique. Study included participants with age less than or equals to 45 and participants from both genders.However, participants with Age more than 45and those having non ST myocardial infarction were excluded. After the approval from Pakistan Institute of Medical Sciences, Cardiology department, Islamabad, Pakistan ethical committee, Consent was taken from patients having MI, diagnosed on basis of rise and/or fall of troponin, absolute change of 7 to 9 ng/l along with supportive evidence in the form of typical symptoms, shortness of breath, heart pain or palpitations and suggestive electrocardiographic (ECG) changes showingSTEMI .ECG showing ST-segment elevation of at least 0.1 mV (1 mm) in two consecutive leads. Selected patients from department of Cardiology.Medical records were analyzed for the patient’s MI risk factor profile i.e. history of diabetes, hypertension, hyperlipidemia, family history and smoking. BMI was also noted to check for obesity, history about lifestyle was also noted and type of MI was also assessed based on ST segment elevation to check if MI was ST segment elevation MI or non-ST segment elevation MI. Details of the coronary angiogram, laboratory investigations, and cardiac biomarker including trop T, I and CK-MB werenoted. Fasting lipid profile was noted to check for level of lipids. Examination findings including Blood pressure, pulse, respiratory rate, cyanosis, S3, Killip class and JVP were noted.Data was entered and analyzed using statistical package for social sciences (SPSS) version 2.0 and different descriptive and analytical statistics was applied according to the type of data. Mean +- SD was calculated for the quantitative variable like age. Frequencies and percentages were computed for categorical variables like gender. P value of < 0.05 was considered as significant. RESULTS In study analysis it was found that out of total 164 participants, study included 155 males (94.5%) and 9 females