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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Clinical profile and prognosis of young patients with ST-elevation myocardial infarction managed by the

Eduardo Flores-Umanzor1, Pedro Cepas-Guillén1, Xavier Freixa1

  • 1Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain.

Revista Espanola De Cardiologia (English Ed.)
|March 23, 2023
PubMed

Insights

Younger patients with ST-elevation myocardial infarction (STEMI) have better outcomes despite higher-risk features. However, women under 45 experienced longer ischemia times and less percutaneous coronary intervention (PCI).

Area of Science:

  • Cardiology
  • Acute Myocardial Infarction Research
  • Clinical Outcomes Analysis

Background:

  • Limited data exists on the clinical profile and outcomes of younger patients experiencing ST-elevation myocardial infarction (STEMI).
  • Understanding these differences is crucial for optimizing treatment strategies in diverse patient demographics.
  • Sex-based disparities in STEMI presentation and management among younger individuals require further investigation.

Purpose of the Study:

  • To compare clinical characteristics and outcomes of STEMI patients aged <45 years versus those aged ≥45 years.
  • To analyze sex-based differences in clinical presentation, treatment, and outcomes within the younger STEMI cohort.
  • To evaluate the impact of age and sex on mortality rates following STEMI.

Main Methods:

  • A multicenter study utilizing data from the Catalonian Acute Myocardial Infarction (AMI) Code network (2015-2020).
  • Inclusion criteria: patients with an admission diagnosis of STEMI.
  • Primary endpoints: all-cause mortality at 30 days, 1 year, and 2 years post-STEMI.

Main Results:

  • Younger STEMI patients (<45 years, 7.4% of cohort) were more likely smokers and presented with cardiac arrest and TIMI 0 flow before percutaneous coronary intervention (PCI).
  • Despite higher-risk admissions, younger patients demonstrated significantly lower all-cause mortality rates compared to older patients (P<.001).
  • Within the younger cohort, women experienced higher rates of cardiogenic shock (P=.002), longer symptom-to-reperfusion times (P<.05), and were less likely to receive PCI (P=.004) than men.

Conclusions:

  • Younger STEMI patients achieve better survival outcomes than older counterparts, even with more severe initial presentations.
  • Significant sex-based differences exist in STEMI management for young patients, including longer ischemia times and reduced PCI rates for women.
  • These findings highlight the need for tailored approaches to STEMI care, considering both age and sex.
Abstract

Keywords:
Acute myocardial infarctionCoronary artery diseaseDiferencias por sexoEnfermedad coronariaIAMCESTInfarto agudo de miocardioPacientes jóvenesSTEMISex gapYounger patients

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