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Updated: Feb 3, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
[ST elevation myocardial infarction in young adults: Is there an interest for thrombophilia screening?]
V Spagnoli1, M Diefenbronn1, B Merat1
1Service de cardiologie, hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France.
Insights
Thrombophilia screening in young adults with ST-elevation myocardial infarction (STEMI) identified abnormalities in 43% of cases. This screening can lead to adjusted antithrombotic treatment strategies for these patients.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Patient thrombogenicity and coronary lesion characteristics influence coronary events.
- In younger patients, thrombogenicity may be a more significant factor than local conditions.
- Assessing thrombophilia in young patients can guide tailored therapeutic management.
Purpose of the Study:
- To determine the prevalence of thrombophilia in adults aged 55 years or younger with ST-elevation myocardial infarction (STEMI).
- To evaluate potential modifications in therapeutic management based on thrombophilia assessment in this demographic.
Main Methods:
- Retrospective analysis of patients aged ≤55 years with STEMI admitted between January 2013 and January 2017.
- Thrombophilia investigation included clinical, biological, and/or angiographic evaluations.
- Comparison of patient characteristics between those who underwent thrombophilia screening and those who did not.
Main Results:
- 133 young adults with STEMI were included; 43% of those screened (n=51) showed thrombophilia abnormalities.
- De novo intra-arterial thrombosis related to atherosclerosis was the primary cause (92%).
- Therapeutic adjustments were made in 12% of patients who underwent thrombophilia assessment.
Conclusions:
- Thrombophilia screening is valuable in young STEMI patients, revealing abnormalities in a significant portion.
- Demonstrating thrombophilia allows for potential modifications in antithrombotic treatment.
- This approach may optimize management for young adults experiencing myocardial infarction.
Background:
Coronary lesions characteristics as well as patient thrombogenicity can explain coronary events manifestation. In young patient, local conditions are usually less important and thrombogenicity could play a significant role. Assessing thrombophilia could be justified in young patients and may induce an adapted therapeutic management.
Purpose:
We aimed to assess the prevalence of thrombophilia and therapeutic modification in young adults aged≤55 years admitted in our department for ST elevation myocardial infarction (STEMI).
Methods:
From January 2013 to January 2017, data on all patients aged≤55 years with STEMI admitted in emergency were retrospectively retrieved from our database. Thrombophilia investigation was made regarding clinical (with or without cardiovascular risk factors [CVRF]), biological and/or angiographic evaluation.
Results:
A total of 133 patients aged≤55 years with STEMI were included. Cardiac arrest occurred in 15 patients (11%). One or less CVRF were found in 47 patients (35%). Smoking was reported in 93 patients (70%) and drug addiction (cannabis, cocaine) in 19 patients (14%). A subset of 51 patients (38%) were screened for thrombophilia. Patients with thrombophilia assessment were younger, less active smokers and presented less CVRF than patients without investigation (P<0.001). Single vessel diseased was found in 88 patients (66%). No differences regarding coronary procedural characteristic were found between the two groups. The most frequently encountered aetiology, found in 122 patients (92%), was de novo intra-arterial thrombosis related to atherosclerosis. In patients with thrombophilia assessment (n=51), one or more abnormal biological results was found in 22 patients (43%) and a therapeutic adjustment was made in 6 patients (12%).
Conclusion:
Thrombophilia screening in young STEMI adults showed an abnormality in 43% of cases. Antithrombotic treatment can be modified after its demonstration.
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