Pathogenesis of acute myocardial infarction in young male adults with or without obesity.

Objectives. Obesity may be linked with coronary atherosclerosis in young males. This study investigated the etiology of acute myocardial infarction (AMI) in young Japanese male patients with or without obesity. Methods and Results. This retrospective study included 2,230 AMI patients enrolled in the AMI-Kyoto Multi-Center Risk Study between January 2000 and December 2005. Clinical background, risk factors, angiographic findings, acute results of primary percutaneous coronary intervention(PCI) , and in-hospital outcome were evaluated in 33 young male patients 25, n = 21) and non-obese group (BMI < 25, n = 12) . Four of the 12 non-obese patients had underlying disease (Kawasaki disease 2, Buerger' s disease 1, drug abuse 1) . The non-obese group had a higher prevalence of underlying disease than the obese group. The non-obese group had a higher incidence of left anterior descending coronary artery as culprit lesion and higher Thrombolysis in Myocardial Infarction (TIMI) grade flow in the infarct-related artery before primary PCI. The acquisition rates of TIMI 3 flow after primary PCI and in-hospital outcome did not differ between the two groups. Conclusions. Non-obese young AMI male patients have a higher frequency of underlying disease. Most young male AMI patients were obese, suggesting that obesity may be important in the pathogenesis of AMI in young male adults.