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Updated: Sep 2, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Acute myocardial infarction in young adults with chronic kidney disease
Karo Gyurjian1, Franz Schweis2, Sej Patel3
1Departments of Internal Medicine.
Insights
Chronic kidney disease (CKD) affects 6.8% of young patients with acute myocardial infarction (AMI). CKD significantly increases mortality risk in this population, underscoring the need for aggressive risk management.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Renal dysfunction is a known cardiovascular risk factor in older adults.
- The impact of chronic kidney disease (CKD) on outcomes in young patients experiencing acute myocardial infarction (AMI) is not well understood.
Purpose of the Study:
- To determine the prevalence of CKD in young patients (18-50 years) with AMI.
- To characterize these patients and analyze their clinical outcomes.
- To investigate the association between CKD and mortality in young AMI survivors.
Main Methods:
- Retrospective population-based cohort study.
- Inclusion of patients aged 18-50 presenting with AMI between 2006-2016.
- Review of medical records for diagnosis, treatment, and outcomes.
- Cox regression analysis to assess CKD's impact on mortality.
Main Results:
- CKD was identified in 6.8% of 1753 young AMI patients.
- CKD patients exhibited higher rates of hypertension, hyperlipidemia, diabetes, and obesity.
- CKD was linked to significantly higher all-cause mortality (adjusted HR 3.6) over 7.2 years.
- Lower utilization of statins and P2Y12 inhibitors was observed in CKD patients post-AMI.
Conclusions:
- CKD is present in a notable proportion of young AMI patients and is associated with a 3.6-fold increased mortality risk.
- Suboptimal use of guideline-directed therapies like statins and P2Y12 inhibitors in CKD patients warrants attention.
- Intensified risk factor modification and optimal medical therapy are crucial for improving outcomes in young AMI patients with CKD.
Objective:
The goal of this study was to evaluate the prevalence of chronic kidney disease (CKD) in young patients with acute myocardial infarction (AMI) and to report their characteristics and clinical outcomes.
Background:
Underlying renal dysfunction is a risk factor for poor cardiovascular outcomes in older patients. The implication of CKD in young patients with AMI is not well studied.
Methods:
This is a retrospective population-based cohort study of patients aged 18-50 who presented with AMI between 2006 and 2016. Medical records were reviewed to confirm diagnosis and to identify treatment and long-term outcomes. Cox regression models were used to evaluate the association of CKD with mortality.
Results:
Among 1753 young patients with type 1 AMI (median age 45 years, 85.3% male), CKD was present in 112 (6.8%) patients. A higher proportion of CKD patients had concomitant hypertension, hyperlipidemia, diabetes, and obesity. Use of statin and P2Y12 inhibitors post-AMI was lower in CKD patients. Over a median follow-up of 7.2 years, CKD was associated with higher all-cause mortality [hazard ratio (HR), 9.3; 95% CI, 6.3-13.8]. This association persisted after adjusting for demographics, comorbidities, and treatment (adjusted HR, 3.6; 95% CI, 2.2-6.0).
Conclusion:
Presence of CKD was associated with 3.6-fold higher mortality over a median follow-up of 7.2 years. A lower proportion of CKD patients were treated with statin therapy and P2Y12 inhibitors. These findings highlight the need for intensive risk factor modification and optimal use of guideline-directed medical therapies in this high-risk population.
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