Trends of myocardial infarction in young patients

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• While overall ST-elevation myocardial infarction (STEMI) rates have declined, a concerning trend of increasing incidence and mortality is observed in younger adults (18-40 years).
• Understanding the trajectory of STEMI in this demographic is crucial for developing targeted public health interventions.

Purpose of the Study:

• To investigate the trends in STEMI incidence, mortality, and mechanical circulatory support (MCS) utilization among young adults aged 18-40.
• To evaluate the changes in major cardiovascular risk factors within the same cohort over the study period.

Main Methods:

• Analysis of a large cohort (34,888,311 patients) aged 18-40 from the TriNetX Research Network database (2004-2023).
• Linear regression was used to assess incidence rates of STEMI, mortality, and MCS utilization.
• Evaluation of cardiovascular risk factors including diabetes, hypertension, nicotine dependence, obesity, and substance use disorders.

Main Results:

• STEMI incidence significantly increased from 2004 to 2023 (1.59/100,000 person-years).
• Mortality incidence rose annually by 108/100,000, and MCS utilization increased by 38.8/100,000.
• Significant increases in major cardiovascular risk factors were also observed in this young adult population.

Conclusions:

• STEMI incidence, mortality, and MCS utilization have notably increased in young adults between 2004 and 2023.
• A steeper upward trend was observed in the post-COVID era, highlighting an urgent need for further investigation.
• Effective prevention and treatment strategies for STEMI in young adults, especially in the post-COVID context, require immediate research focus.