Ekologiya cheloveka (Human Ecology)Ekologiya cheloveka (Human Ecology)1728-08692949-1444Eco-Vector1743510.17816/humeco17435Research ArticleETIOLOGIC ASPECTS OF ACUTE MYOCARDIAL INFARCTION IN PERSONS UNDER 45BelyakovaI Vlera1@atknet.ruMukhinaP N-SupryadkinaT V-VorobyevaN A-SovershaevA L-Northern State Medical UniversityNorthern Branch of Hematologic Research Center of Ministry of Healthcare and Social Development RFMunicipal Clinical Hospital № 1 named after E. E. Volosevitch15092012199465223102019Copyright © 2012, Belyakova I.V., Mukhina P.N., Supryadkina T.V., Vorobyeva N.A., Sovershaev A.L.2012Relevance. Of particular concern and anxiety among clinicians is incipience of the current unfavorable trend "rejuvenation" of the coronary heart disease (CHD). It is known that in patients under 40, incidence of acute myocardial infarction (AMI) is about 7 % of all cases reported under the age of 65 years. Younger patients are the most active members of the society. In this regard, the study of etiologic aspects, and the search for new pathogenetic mechanisms of acute myocardial infarction is an important task, which defined the purpose of our cohort study. Objective. The aim of our study was to study acute myocardial infarction etiological aspects in patients under 45. Materials and methods. In the period from 1999 till 2008, 221 patients were treated in the Emergency Care Unit with diagnosis of acute myocardial infarction under 45, what represented 8.3 % of all treated patients with AMI. 132 patients with acute myocardial infarction, residents of Arkhangelsk, were examined. We carried out a retrospective analysis of medical records to assess epidemiological components. Results. The analysis has revealed AMI in the patients under 45 years in 8.3 % of cases. Among risk factors of coronary artery disease, we observed: lipid metabolism impairments in 100 % of cases, smoking occurred in 75 % of cases. Hypertension as a risk factor was observed in 68 % of patients. The fact of physical inactivity was reported in 56 % of patients. 55 % of patients were overweight or suffered from obesity. 42 % of the observed patients had coronary artery disease in their family history. According to CAG, 98.8 % of the patients had significant coronary lesions, while 65% of patients had a multivessel disease. A statistically significant relationship F = 10.339, (ρ = 0.002) between genetic predisposition and AMI in the young patients has been revealed. This fact motivated us to conduct molecular-genetic testing of blood. As a result, we identified violent pathological polymorphisms in the hemostatic system in relation to atherosclerosis. This fact induces for further researches in this direction.cardiovascular diseasesrisk factorsyoung personsacute myocardial infarctionсердечно-сосудистые заболеванияфакторы рискаострый инфаркт миокарда[Белякова И. В., Совершаев А. Л., Супрядкина Т. В., Голубева П. Н., Воробьева Н. А. Острый коронарный синдром: отдаленные результаты лечения в зависимости от генотипа пациента // Материалы III съезда кардиологов Приволжского федерального округа. Самара, 2010. С. 160.][Жугинисов Д. Ш. Особенности коронарного шунтирования у пациентов молодого возраста : автореф. дис. канд. мед. наук. Москва, 2008. 24 с.][Зволинская Е. Ю., Александров А. А. Риск развития сердечно-сосудистых заболеваний у лиц молодого возраста // Кардиология. 2010. № 8. С. 37-47.][Миролюбова О. А., Добродеева Л. К. Иммунологические аспекты атеросклероза. Архангельск, 2005. 126 с.][Оганов Р. Г., Масленникова Г. Я. Профилактика сердечно-сосудистых заболеваний - реальный путь улучшения демографической ситуации в России // Кардиология. 2007. № 47(1). С. 4-7.][Поляков В. П., Павлова Т. В. Кардиологические аспекты нарушений системы гемостаза. Самара, 2007. 213 с.][Статистические материалы «Заболеваемость населения России в 2006 году». Ч. 3 / Министерство здравоохранения и социального развития РФ. Департамент развития медицинской помощи и курортного дела ФГУ Центральный научно-исследовательский институт организации и информации здравоохранения Росздрава. М., 2007.][Торшин И. Ю., Громова О. А. Сосудистые заболевания сердца, мозга и молекулярные гены. Ассоциативные исследования и патофизиология сосудистых заболеваний // Трудный пациент. 2008. № 2. С. 23.][Шевченко О. П., Природова О. Ф., Шевченко А. О. Клиническое значение растворимого CD40 лиганда у больных ишемической болезнью сердца // Кардиоваскулярная терапия и профилактика. 2006. № 5. С. 101-111.][Школьникова М. А. Сердечно-сосудистые заболевания детского возраста на рубеже XXI века // Consillium Medicum. 1999. №1. С. 240-245.][Berenson G. S., Srinivasan S. R., Boo W., et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study // N. Engl. J. Med. 1998. Vol. 339. P 1650-1656.][Perrone J., Hollander J. E., De Roos F., Berenson G. S. Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults // N. Engl. J. Med. 1998. Vol. 339. P. 1083-1084.][Strong J. P., Malcom G. T., McMahan C. A., et al. Prevalence and extent of atherosclerosis in adolescentns and young adults:implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study // JAMA. 1999. Vol. 281. P 727-735.][Wang T. J., Gona P., Larson M. G., et al. Multiple biomarkers for the prediction of first major cardiovascular events and death // N. Engl. J. Med. 2006. Vol. 355. P. 2631-2639.]