Myocardial infarction in the young and in women

Although only 2 percent to 6 percent of MIs occur in young patients, this disorder represents a major cause of long-term disability in this group. In these patients, an increased number of conventional risk factors has been observed, with cigarette smoking being the most prevalent. Angiography in young patients with MI most often demonstrates single-vessel CAD and slow progression of atherosclerosis. When multivessel CAD is found, the long-term prognosis is less favorable. In women, CAD is more likely to present as angina than MI or sudden death. Cigarette smoking and oral contraceptive use are important risk factors. Although MIs in women occur less often than in men, women experience a less favorable acute and long-term prognosis.