Acute ST-elevation myocardial infarction in young patients: 15 years of experience in a single center
Su-Kiat Chua1, Huei-Fong Hung, Kou-Gi Shyu
1Division of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Taipei, Taiwan.
Insights
Young patients with ST-elevation myocardial infarction (STEMI) exhibit distinct risk factors like smoking and obesity, but experience better outcomes than older patients. Modifiable factors are key for managing STEMI in younger individuals.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Limited research exists on young patients experiencing ST-elevation myocardial infarction (STEMI).
- Understanding STEMI in younger demographics is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To investigate the clinical characteristics and coronary angiographic features of young patients with STEMI.
- To compare outcomes between young (< or =45 yrs) and older (>45 yrs) STEMI patients.
Main Methods:
- Data from 849 consecutive STEMI patients (1992-2006) were analyzed.
- Baseline clinical characteristics, coronary anatomy, and outcomes were compared between young and older patient groups.
Main Results:
- Young STEMI patients (11.6%) were predominantly male, more likely to smoke, be obese, and have dyslipidemia.
- Younger patients showed shorter hospital stays, less in-hospital morbidity and mortality, and significantly lower follow-up mortality.
- Killip class III or IV predicted in-hospital outcomes in young STEMI patients; repeated PCI and reinfarction rates were similar between groups.
Conclusions:
- Smoking, obesity, and dyslipidemia are key modifiable risk factors for STEMI in young patients.
- Young STEMI patients demonstrate better outcomes than older counterparts, with comparable rates of repeat PCI and reinfarction.
- Killip class III or IV is a significant predictor of in-hospital morbidity and mortality in young STEMI patients.
Background:
There have been few studies done regarding young patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate the clinical characteristics and coronary angiographic features in young patients with STEMI.
Methods:
We collected data on 849 consecutive patients with STEMI from 1992 to 2006. Baseline clinical characteristics, coronary anatomy, and outcome were compared in young (< or =45 yrs) and older patients (>45 yrs).
Results:
Young patients presented 11.6% of all patients with STEMI. These patients were predominantly male (92.9% vs 80.3%, P < 0.001), more likely to smoke (75.8% vs 47.2%, P < 0.001), obese (48.2% vs 27.9%, P = 0.002), have higher triglyceride levels (176.9 +/- 153.8 mg/dL vs 140.7 +/- 112.7 mg/dL, P = 0.005), and lower high-density lipoprotein cholesterol (37.1 +/- 7.9 mg/dL vs 42.8 +/- 14.3 mg/dL, P = 0.005) than older patients. Also, younger patients had a shorter hospital stay (7.1 +/- 4.9 d vs 8.5 +/- 6.7 d, P = 0.04), less in-hospital morbidity (29.3% vs 39.7%, P = 0.02), and mortality (3.0% vs 12.3%, P = 0.002). Killip class III or IV could predict in-hospital morbidity and mortality in young patients. Both groups had similar rates of repeated percutaneous coronary intervention (PCI; 45.5% vs 41.5%, P = 0.23) and reinfarction (6.1% vs 3.2%, P = 0.32). Mortality rate during follow-up was significantly lower in younger patients (3.0% vs 19.6%, P < 0.001).
Conclusion:
Cigarette smoking, obesity, and dyslipidemia were the most important modifiable risk factors in young patients with STEMI. These patients had a better outcome than older patients without differences in repeated PCI and reinfarction between them. Only Killip class III or IV could predict in-hospital morbidity and mortality in young patients with STEMI.
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