Clinico-Biochemical Profile and Outcomes in Young Adults With ST-Segment Elevation Myocardial Infarction at a
Jeyanth K1, Kavitha B2, Surendar R3
1Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, IND.
Insights
Young adults experiencing ST-elevation myocardial infarction (STEMI) have distinct risk factors like smoking and higher inflammatory markers. Despite timely treatment, thrombolysis is less successful in younger STEMI patients, indicating a need for targeted prevention and early invasive strategies.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) in young adults is a growing concern with unique risk factors and outcomes.
- Limited data exists on STEMI in the Indian population, especially concerning thrombolysis effectiveness in younger individuals.
Purpose of the Study:
- To compare clinical profiles, risk factors, laboratory findings, and outcomes of STEMI in young adults (≤45 years) versus older patients (>45 years).
- To specifically evaluate and compare thrombolysis outcomes between these age groups in the Indian context.
Main Methods:
- Prospective observational study involving 60 STEMI patients over six months at a tertiary care center.
- Patients divided into two groups: young (≤45 years, n=16) and older (>45 years, n=44).
- Comparison of clinical presentation, risk factors, lab parameters, ECG, thrombolysis details, and outcomes using chi-square tests (p<0.05 significance).
Main Results:
- Younger STEMI patients were predominantly male and had higher prevalence of smoking (43.8% vs 15.9%, p=0.024).
- Older patients showed a higher incidence of diabetes mellitus (54.5% vs 25.0%, p=0.042).
- Younger patients exhibited significantly higher white blood cell (p=0.006) and platelet counts (p=0.009).
- Despite similar door-to-needle times, successful thrombolysis was significantly lower in young adults (43.8% vs 75.0%, p=0.023).
Conclusions:
- Young STEMI patients present with distinct risk profiles, including modifiable factors and heightened prothrombotic/inflammatory states.
- Reduced thrombolysis success in younger patients, despite timely reperfusion, suggests potential resistance to this treatment.
- Findings support targeted prevention strategies and consideration of early invasive approaches for young STEMI patients.
Abstract:
Background ST-elevation myocardial infarction (STEMI) in young adults is increasingly recognized, with distinct risk factor profiles and potential differences in clinical outcomes compared to older patients. However, data from the Indian context remain limited, particularly regarding thrombolysis response. Objectives The aim of this study was to compare the clinical profile, risk factors, laboratory parameters, and outcomes of STEMI between young adults (≤45 years) and older patients (>45 years), with a focus on thrombolysis outcomes. Methods This prospective observational study included 60 patients with STEMI admitted to a tertiary care center over six months. Patients were categorized into young (≤45 years, n=16) and older (>45 years, n=44) groups. Clinical presentation, risk factors, laboratory parameters, electrocardiographic findings, thrombolysis characteristics, and outcomes were compared. Statistical analysis was performed using the chi-square test for categorical variables, with p<0.05 considered significant. Results Young adults constituted 16 (26.7%) cases and were predominantly male (45, 75.0%). Smoking was significantly more prevalent among younger patients (seven, 43.8% vs seven, 15.9%, p=0.024), while diabetes mellitus was more common in older patients (24, 54.5% vs four, 25.0%, p=0.042). Clinical presentation and ECG patterns were comparable between the groups. Younger patients had significantly higher white blood cell counts (11993.75 ± 3630.70 vs 9479.55 ± 2791.23 /µL, p=0.006) and platelet counts (312250 ± 75964.47 vs 261045.45 ± 60385.18 /µL, p=0.009). Despite similar door-to-needle times, successful thrombolysis was significantly lower among younger patients (seven, 43.8% vs 33, 75.0%, p=0.023). Overall clinical outcomes were comparable between the groups (p=0.227). Conclusion Young STEMI patients exhibit a distinct risk profile dominated by modifiable factors and demonstrate reduced thrombolysis success despite timely reperfusion, suggesting a heightened prothrombotic and inflammatory state. These findings underscore the importance of targeted prevention and support consideration of early invasive strategies in younger patients, warranting further large-scale studies.
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