Myocardical Infarction in Young Adults: Revisiting Risk Factors and Atherothrombotic Pathways

Area of Science:

• Cardiology
• Internal Medicine
• Preventive Medicine

Background:

• Myocardial infarction (MI) in young adults is an emerging clinical issue.
• Younger patients often lack traditional cardiovascular risk factors and advanced atherosclerosis.
• This necessitates reevaluation of MI pathophysiology and risk assessment in this demographic.

Purpose of the Study:

• To review the epidemiology, pathophysiology, and diagnostic challenges of MI in adults under 55.
• To differentiate between traditional and emerging risk factors for MI in young adults.
• To highlight non-atherosclerotic mechanisms contributing to MI in this population.

Main Methods:

• Narrative literature review focusing on studies from the last five years.
• Inclusion of data from large registries, cohort studies, and experimental findings.
• Emphasis on MI in young adults (under 55 years).

Main Results:

• Young adults with MI present with diverse risk factor profiles, including traditional and emerging factors.
• Emerging contributors include elevated lipoprotein(a), recreational drug use, autoimmune conditions, and psychosocial stress.
• Non-atherosclerotic mechanisms like spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome are relevant.

Conclusions:

• MI in young adults is a distinct entity requiring tailored diagnostic and management strategies.
• Understanding unique risk factors and pathophysiologies is crucial for effective prevention and treatment.
• Further research is needed to refine risk assessment and therapeutic approaches for this population.