Clinical features of ST-segment elevation myocardial infarction in young Chinese patients
Yunjuan Sun1, Jialiang Xu1, Zhisong He1
1Department of Cardiology, the First Affiliated Hospital of Soochow Univer sity, Suzhou, Jiangsu Province, People's Republic of China.
Insights
Young adults experiencing ST-segment elevation myocardial infarction (STEMI) present with distinct characteristics and a significantly lower in-hospital mortality risk compared to older individuals. This study highlights key differences in risk factors and clinical outcomes for acute myocardial infarction in younger populations.
Area of Science:
- Cardiology
- Internal Medicine
- Epidemiology
Background:
- Acute myocardial infarction (MI) incidence is rising among younger adults globally.
- Understanding the specific clinical profiles and outcomes of young MI patients is crucial for targeted prevention and treatment strategies.
- Chinese populations may exhibit unique demographic and clinical characteristics regarding acute myocardial infarction.
Purpose of the Study:
- To investigate the clinical characteristics, angiographic findings, and in-hospital outcomes of young adults (≤50 years) with acute myocardial infarction (MI).
- To compare these findings between young adults and older patients (>50 years) with ST-segment elevation myocardial infarction (STEMI).
- To identify independent risk factors for in-hospital survival in acute STEMI patients.
Main Methods:
- An observational study consecutively enrolled 549 patients with first-time ST-segment elevation myocardial infarction (STEMI) between January 2013 and December 2015.
- Patients were divided into two groups: 'young group' (≤50 years) and 'non-young group' (>50 years).
- Clinical features, angiographic findings, and in-hospital outcomes were compared between the two groups using statistical analysis, including multivariable logistic regression.
Main Results:
- The young group (131 patients) differed from the non-young group (418 patients) with a higher proportion of males, smokers, fewer chronic diseases, lower NT-proBNP, higher triglycerides, and lower HDL-C.
- The young group exhibited a significantly lower in-hospital mortality rate (1 death out of 131) compared to the non-young group (27 deaths out of 418).
- Younger patients were more likely to have single-vessel disease and intracoronary thrombus, and less likely to require multiple stents.
Conclusions:
- Young adults with STEMI have distinct clinical and angiographic profiles, characterized by fewer comorbidities and a more favorable lipid profile, alongside a significantly lower risk of in-hospital death.
- Factors such as older age, advanced Killip class, higher white blood cell count, and elevated NT-proBNP are independent predictors of mortality in acute STEMI.
- The findings underscore the need for tailored management approaches for acute myocardial infarction in different age demographics.
Background:
To investigate the clinical characteristics, angiographic findings and clinical outcomes (in-hospital) of young adults with acute myocardium infarction in a Chinese population.
Methods:
This was an observational study. Five hundred and forty-nine patients who suffered with ST-segment elevation myocardial infarction (STEMI) firstly between January 2013 and December 2015 were enrolled consecutively. All patients were divided into two groups: "young group" patients were ≤ 50 years old; and "non-young group" patients were > 50 years old. Clinical features were compared, angiographic findings and clinical outcomes were observed between the two groups.
Results:
There were 131 and 418 patients included in the young group and the non-young group, respectively. Twenty-eight patients suffered deaths during the hospital stay and only one death occurred in the young group. Compared with non-young group, the young group was associated with male, smoke, fewer chronic diseases, Killip class I on admission, lower level of N-terminal pro B-type natriuretic peptide (NT-proBNP), higher level of triglyceride and lower level of high-density lipoprotein cholesterol (HDL-C), single-vessel lesion and intracoronary thrombus (p < 0.005). The average length of hospital stay of non-young group was 1.5 days longer than the young group. Compared with the non-young group, the young group inclined not to use or use only one stent (p = 0.026). Multivariable logistic regression analysis showed that older age, shorter hospital stay, advanced Killip class III/IV, increased white blood cell and NT-proBNP were independent risk factors for survival in acute STEMI patients during hospitalization (p < 0.005).
Conclusions:
Compared with non-young group, the young group was associated with male, smoke, higher level of triglyceride and lower level of HDL-C. The condition of patients in young group were relatively mild and the risk of death during hospitalization was lower than the other group.
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