Young Patients Presenting With Suspected ST-Elevation Myocardial Infarction Undergoing Emergency Coronary...

This study aimed to determine the demographic and clinical profiles, cardiovascular risk factors, and variables independently associated with major adverse cardiovascular events (MACE) during 1-year follow-up in young patients aged 45 years or younger who presented with suspected ST-segment elevation myocardial infarction (STEMI) and underwent emergency coronary angiography.

This retrospective, single-center, observational study included 126 young patients presenting with suspected STEMI who underwent primary coronary angiography and/or percutaneous coronary intervention at a high-volume tertiary cardiovascular center between January 2021 and April 2025. Patients were classified into two groups according to the occurrence of MACE during 1-year follow-up: the MACE group (n=28) and the non-MACE group (n=98). HbA1c levels were assessed based on a single measurement obtained during the index MI admission. Logistic regression analyses were performed to identify variables independently associated with MACE.

The median age of the overall cohort was 40 years (38-42), and 7.9% of the patients were female. During follow-up, MACE occurred in 22.2% of the patients. The all-cause mortality rate was 4.0%. Multivariable logistic regression analysis demonstrated that higher HbA1c levels (aOR: 1.57; 95% CI: 1.10-2.24; P = 0.014), a history of CAD (aOR: 3.93; 95% CI: 1.15-13.37; P = 0.029), and lower LVEF (aOR: 0.94; 95% CI: 0.88-0.99; P = 0.029) were independently associated with MACE. Notably, among patients without previously known diabetes, HbA1c levels ≥6.5% were significantly associated with an increased risk of MACE.

Young patients presenting with suspected STEMI who undergo emergency coronary angiography may have a notable risk of MACE during the first year of follow-up. A history of CAD, lower LVEF, and elevated HbA1c levels appear to be associated with adverse clinical outcomes.