Clinical risk factors and outcomes of young patients with acute ST segment elevation myocardial infarction: a
Ming-Ting Liang1,2, Ying Pang2, Li-Li Gao2
1Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Insights
Younger patients with ST-elevation myocardial infarction (STEMI) have distinct risk factors including smoking and alcohol use disorder. Hyperuricemia is a key risk factor in this demographic, necessitating targeted interventions.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) typically affects older populations.
- Understanding the clinical profile of younger STEMI patients is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To analyze the clinical characteristics and prognosis of acute STEMI in patients aged 45 years or younger.
- To compare these characteristics with older STEMI patients.
Main Methods:
- Retrospective analysis of 701 STEMI patients from January 2018 to March 2021.
- Comparison of clinical features, management, and outcomes between patients ≤45 years and >45 years.
- Average follow-up duration of 11.5 months.
Main Results:
- Younger STEMI patients (15.4%) were more likely male, smokers, with alcohol use disorder (AUD), or family history of ischemic heart disease (IHD).
- Left anterior descending (LAD) artery was the culprit vessel more often in younger patients, potentially linked to smoking.
- Younger patients had higher LDL, lower HDL, and significantly higher uric acid levels; diabetes trended towards major adverse cardiovascular events (MACE).
Conclusions:
- Smoking, AUD, and family history of IHD are more prevalent in young STEMI patients.
- Hyperuricemia, not dyslipidemia, is a significant risk factor in patients ≤45 years.
- Diabetes management is essential for reducing cardiovascular events in young STEMI patients.
Background:
This study aimed to analysis the clinical characteristics and prognosis of acute STEMI in patients aged ≤ 45 years.
Methods:
Seven hundred and one patients with STEMI from Liaocheng People's Hospital from January 2018 to March 2021 were included in this study. Clinical characteristics, management, and outcomes (average follow-up: 11.5 months) were compared between patients aged ≤ 45 years and those aged > 45 years.
Results:
Of the patients with STEMI who underwent primary percutaneous coronary intervention, 108 (15.4%) were aged ≤ 45 years. Compared to the older group, the younger patient group included more males, current smokers, and those with alcohol use disorder (AUD) or a family history of ischaemic heart disease (IHD). The culprit vessel in young patients was the left anterior descending (LAD) artery (60% vs. 45.9%, P = 0.031), which may have been due to smoking (odds ratio, 3.5; 95% confidence interval: 1.12-10.98, P = 0.042). Additionally, young patients presented with higher low-density lipoprotein and lower high-density lipoprotein levels than older patients; uric acid levels were also significantly higher in younger patients than that in the older group. Diabetes showed a trend toward major adverse cardiovascular events (MACE) in both groups; age and sex were both independent predictors of MACE in older patients.
Conclusion:
More patients who were smokers, had AUD, or a family history of IHD were present in the young patient group. Hyperuricaemia (but not dyslipidaemia) was a prevalent risk factor in patients aged ≤ 45 years. Diabetes should be controlled to reduce cardiovascular events in young patients.
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