Risk Factors, Use of Revascularization, and Outcomes in Young Adults With ST-Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Acute myocardial infarction incidence is rising in younger populations.
• Gender disparities exist in myocardial infarction treatment and outcomes.
• Young adult ST-elevation myocardial infarction (STEMI) is understudied, lacking direct comparisons with older adults.

Purpose of the Study:

• To compare risk factors, treatment, and outcomes of STEMI in young adults versus older adults.
• To investigate gender-based differences in STEMI within different age groups.

Main Methods:

• Retrospective observational study utilizing New York State's Statewide Planning And Research Cooperative System (SPARCS) data.
• Analysis of STEMI admissions between 2011 and 2018.
• Comparison of demographic, clinical characteristics, treatment, and 1-year mortality across age groups and genders.

Main Results:

• Young adults (<50 years) with STEMI showed higher rates of obesity, tobacco use, substance use, and psychiatric disorders.
• Younger patients were more likely to receive revascularization and had lower 1-year mortality compared to older adults.
• Female patients consistently had a higher comorbidity burden, received revascularization less frequently, and experienced increased 1-year mortality across all age groups.

Conclusions:

• Young adults with STEMI present with a unique profile of risk factors and comorbidities.
• Revascularization significantly reduces 1-year mortality in STEMI patients across all age groups.
• Female gender is associated with worse outcomes in STEMI, highlighting a need for targeted interventions.