Incidence, risk factors and outcome of young patients with myocardial infarction
Jarle Jortveit1, Are Hugo Pripp2, Jørund Langørgen3
1Department of Cardiology, Sørlandet Hospital Arendal, Arendal, Norway jarle.jortveit@sshf.no.
Insights
Acute myocardial infarction (AMI) is less common in younger adults, but those under 45 experiencing AMI face significant risks. Nearly 10% of young AMI patients had new cardiovascular events or died within three years.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Declining trends in acute myocardial infarction (AMI) incidence and mortality are less pronounced in younger populations compared to older individuals.
- Understanding the specific characteristics of AMI in younger demographics is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To investigate the incidence, risk factors, and outcomes of acute myocardial infarction (AMI) in patients younger than 45 years.
- To provide a comprehensive nationwide analysis of early-onset AMI in Norway.
Main Methods:
- An observational, nationwide cohort study utilizing data from the Norwegian Myocardial Infarction Register (2013-2016).
- Inclusion criteria encompassed all patients aged 80 years or younger diagnosed with AMI.
- Follow-up data were obtained through linkage with the Norwegian Patient Registry up to 2017.
Main Results:
- Out of 33,439 AMI patients, 1468 (4.4%) were under 45 years old.
- Younger patients (<45 years) were more frequently male, smokers, obese, and had a family history of premature AMI, with higher LDL-cholesterol levels.
- Patients under 45 had a higher incidence of non-obstructive coronary artery disease (14% vs. 10%) and experienced new AMI, stroke, or death at a rate of 9% during follow-up.
Conclusions:
- While the incidence of AMI is low in individuals under 45 in Norway, outcomes are concerning, with nearly 10% experiencing major adverse cardiovascular events or death.
- There is a clear need for enhanced risk factor management strategies in younger populations to mitigate the long-term impact of AMI.
Objective:
The decline in the incidence and mortality of acute myocardial infarction (AMI) has been less among younger compared with older individuals. The aim of this nationwide study was to assess the current incidence, risk factors and outcome of AMI in patients <45 years of age.
Methods:
All patients ≤80 years of age registered in the Norwegian Myocardial Infarction Register in 2013-2016 were included in this observational, nationwide cohort study. Follow-up was conducted through linkage with the Norwegian Patient Registry through 2017.
Results:
Among a total of 33 439 patients ≤80 years with AMI, 1468 (4.4%) were <45 years old. The incidence of AMI was 2.1 per 100 000 person-years in people aged 20-29 years, 16.9 in people aged 30-39 years and 97.6 in people aged 40-49 years. Compared with older patients, patients <45 years were more likely to be male (81%), current smokers (56%), obese (30%) and have a family history of premature AMI (44%), and their low-density lipoprotein-cholesterol levels were higher. Patients <45 years were more likely to have non-obstructive coronary artery disease (14% vs 10%, p<0.001) compared with older patients. During a median follow-up time of 2.4 years, 135 (9%) patients <45 years experienced a new AMI, stroke or death, and 58 (4%) patients died.
Conclusions:
The rate of AMI was low in people <45 years old in Norway, but almost one in ten patients with AMI <45 years old died or experienced a new cardiovascular event during follow-up. Increased efforts to improve risk factor control in these patients are warranted.
Related Concept Videos
01:14Myocarditis III: Medical Management
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Myocarditis IV: Nursing Management
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...