Clinical Characteristics and Prognosis of Young Middle Eastern Adults with ST-Elevation Myocardial Infarction:
Omar Sami Obeidat1, Hanna Makhamreh1, Ra'ad Zaid Al-Muhaisen2
1Department of Internal Medicine, The University of Jordan, Amman, Jordan.
Insights
Young Middle Eastern adults with ST-elevation myocardial infarction (STEMI) are typically male smokers with fewer risk factors. While one-year outcomes were similar, younger STEMI patients showed lower mortality rates.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Limited research exists on premature ST-elevation myocardial infarction (STEMI) in the Middle East.
- Understanding the characteristics of young STEMI patients is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To compare the clinical features and one-year prognosis of young (<45 years) versus older (≥45 years) adults experiencing STEMI in the Middle East.
- To identify specific risk factors and outcomes in younger STEMI populations within this region.
Main Methods:
- Prospective enrollment of 706 STEMI patients into the First Jordanian Percutaneous Coronary Intervention Registry.
- Stratification into two age groups: <45 years and ≥45 years.
- Evaluation of baseline clinical variables and one-year major adverse cardiovascular events (MACE).
Main Results:
- Younger patients (17.4%) were predominantly male (96%), smokers (86%), and had less multi-vessel disease (26%) compared to older patients.
- No significant difference in in-hospital or one-year MACE was observed between the age groups.
- Notably, no young patients died within one year, contrasting with a 4% mortality rate in older patients.
Conclusions:
- Young Middle Eastern STEMI patients present with distinct characteristics, including male predominance, smoking, and single-vessel disease.
- Despite similar MACE rates, younger patients demonstrated a better one-year survival outcome.
- Further research is recommended to investigate this vulnerable demographic for improved preventative measures.
Aims:
Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI.
Methods And Material:
A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated.
Results:
Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036).
Conclusions:
Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.
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