Clinical Characteristics, Prognosis, and Gender Disparities in Young Patients With Acute Myocardial Infarction

Area of Science:

• Cardiology
• Public Health
• Gender Medicine

Background:

• Young individuals constitute a notable and growing proportion of acute myocardial infarction (AMI) cases globally.
• Limited data exists on the specific clinical profiles and outcomes for younger AMI patients.
• This study addresses the need for comprehensive analysis of clinical characteristics, prognosis, and gender-based differences in AMI among patients aged 45 years or younger.

Purpose of the Study:

• To investigate the clinical features and outcomes of young patients (≤45 years) with AMI.
• To compare the characteristics and prognosis of young AMI patients with their older counterparts (>45 years).
• To identify and analyze gender disparities in the management and outcomes of AMI within the young patient cohort.

Main Methods:

• Analysis of data from the China Acute Myocardial Infarction registry, including 24,125 patients.
• Comparison of clinical characteristics, treatments, and in-hospital/2-year outcomes between young (≤45 years) and older (>45 years) AMI patients.
• Multivariate regression models to determine predictors of all-cause mortality and gender-specific analyses for young patients.

Main Results:

• Young AMI patients (8.5% of total) were more frequently male, smokers, and had hyperlipidemia compared to older patients.
• Smoking was the primary modifiable risk factor (72.1%) in young AMI patients.
• Young patients received more guideline-based medications and had lower in-hospital and 2-year adverse event rates than older patients.
• Left ventricular ejection fraction and education level predicted 2-year mortality in young patients.
• Young women experienced longer symptom-to-admission times, lower rates of percutaneous coronary intervention, and worse in-hospital and 2-year outcomes compared to young men.

Conclusions:

• Young AMI patients are a significant demographic with distinct risk factors like smoking and hyperlipidemia, yet generally experience better outcomes than older patients.
• Significant gender-based disparities exist in the management and prognosis of AMI among young individuals.
• Targeted interventions and improved healthcare quality are crucial for young women experiencing AMI to address these disparities.