IJCS | Volume 32, Nº2, March/April 2019

172 Figure 6 - Forest plot showing results of comparison between young and older AMI patients for (a) LVEF values; (b) chest pain; (c) all-cause mortality. a b c Lei & Bin Differences of risk factors in young AMI patients Int J Cardiovasc Sci. 2019;32(2)163-176 Review Article Additionally, the benefit of quitting is associatedwith the number of smoked cigarettes, 34 thus identifying cigarette smoking as a major risk factor for young people in AMI is of vital significance. Moreover, creating an awareness of the advantages of smoking cessation may be effective in this group of people to prevent AMI. A positive family history of CAD has often been reported as being another major risk factor for AMI among young patients. 35 Our analysis showed that 43.48% of young AMI patients has a family history of CAD, which is higher than that in older AMI patients (28.27%). Family history of CAD is certainly a major risk factor for young AMI patients. Patients with a family history of CADhavemore severe disease progression and more lipidmetabolismdisorders than those without such a history 36 and are more likely to have insulin resistance and more likely to be obese, possibly resulting from hereditary factors. 37 The analysis suggested that young patients had a higher rate of obesity compared with older patients with AMI (36.58% vs 31.93%). Obesity can double the prevalence of cardiovascular disease. 38 Kragelund et al. 39 said that abdominal obesity appears to be an independent predictor of all-cause mortality in AMI patients. The changes in life and eating habits, and adopting unhealthy habits such as eating fast food or high-fat food can lead to dyslipidemia and abdominal obesity in many young individuals. Previous studies reported that an unhealthy diet, rich in carbohydrates and low in fruits and vegetables are a major risk factor for CVD. 40 Several studies reported that young people tend to consume more red meat with a high fat content and a significantly lower amount of fruits and vegetables compared to the older group. 41,42 Effective interventions, which include a healthy diet and life-style, as well as moderate exercise practice to control body weight may help prevent AMI in young individuals. Diabetes mellitus and hypertension are important risk factors for CAD and are more likely to be associated with older myocardial infarction patients. 43 Our analysis showed that compared with older AMI patients, young AMI patients had a lower rate of hypertension (34.48% vs. 51.2%) and diabetes mellitus (17.02% vs. 24.9%), which is consistent with other studies. 44,45 Anderson et al. 13 said that even though hypertension is more prevalent in older AMI patients, the hazard associated with this risk factor is higher in the young patients.