배경 및 목적:최근 흡연의 증가, 식이습관 변화 등 생활양식의 변화로 인하여 40세 이하의 젊은 연령층에서 동맥경화의 진행에 따른 급성 심근경색증, 협심증 등의 관상동맥 질환이 급격히 증가하는 추세이다. 본 연구에서는 40세 이하의 젊은 한국인 급성 심근경색증 환자에서 관상동맥 중재술 후 추적 관상동맥 조영술시 재협착이 발생하지 않은 군과 발생한 군에 있어서 위험인자 및 임상예후 등을 비교하여 보고자 하였다.방 법:1997년 1월부터 2006년 12월까지 급성 심근경색증으로 관상동맥 중재술을 받은 40세 이하의 환자 121예(35.6±4.0세, 남:여=115:6)중 추적 관상동맥 조영술을 시행받은 88예를 대상으로 재협착이 발생하지 않은 군(Ⅰ군:n=62예, 35.6±3.9세, 남:여=60:2)과 발생한 군(Ⅱ군:n=26예, 36.3±3.8세, 남:여=23:3)에 있어 위험인자 및 임상예후 등을 비교하였다.
결 과:
결 론:
젊은 한국인 급성 심근경색증 환자에서 관상동맥 중재술 후 재협착에 관한 유의한 예측 인자는 높은 혈중 중성지방 수치였다.Background and Objectives:Acute myocardial infarction (AMI) at a young age less than 40 years is an uncommon condition and it is characterized by multiple cardiovascular risk factors. We analyzed the risk factors of restenosis in AMI patients who underwent percutaneous coronary intervention (PCI), and these patients were under the age of 40 years. Subjects and Methods:Between January 1997 and December 2006, 88 out of the 121 young AMI patients (mean age: 35.6±4.0 years, 115 males) who underwent follow-up coronary angiography after PCI were divided into two groups: the patients without restenosis (group I: n=62, mean age: 35.6±3.9 years, 60 males) and the patients with restenosis (group II: n=26, mean age: 36.3±3.8 years, 23 males). The clinical and coronary angiographic characteristics were compared between the two groups. Results:Smoking (79.3%) was the most common risk factor in all the patients. The baseline clinical characteristics and baseline laboratory findings were not different between the two groups. There was no significant difference in the sex ratio (p=0.124). The Thrombolysis In Myocardial Infarction (TIMI) flows were not different between the two groups. The level of homocysteine (hcy) was significantly decreased from 12.4±8.8 μmol/L to 9.3±3. 8 μmol/L in group I (p=0.011), but this was not changed significantly in group II (p=0.062). According to multiple logistic regression analysis, a high triglyceride level (>200 mg/dL) was an independent predictor of restenosis (p=0.046). Conclusion:A high level of serum triglyceride is a predictive factor of restenosis after PCI in young age patients with acute myocardial infarction. (Korean Circulation J 2007;37:373-379)