Premature Myocardial Infarction: Are We Looking Deep Enough to Understand and Manage It?

Premature myocardial infarction (MI) is no longer an uncommon presentation but a growing clinical and public health concern, particularly in Türkiye, where coronary events occur at younger ages than in most European countries. Rising cardiometabolic risk, smoking, inherited lipid disorders, substance use, and psychosocial stress contribute to this burden, while conventional risk scores often fail to identify young individuals at risk. This Young MI focus issue of the Archives of the Turkish Society of Cardiology attracted numerous submissions, reflecting how frequently clinicians now encounter young patients with MI. These submissions also revealed recurring gaps in practice. Key lipid parameters, including lipoprotein(a) and non-HDL cholesterol, were often not assessed; family screening was rarely considered; and non-atherosclerotic causes, substance and energy drink use, and long-term outcomes received limited attention. This editorial discusses the burden and drivers of premature MI, summarizes the contributions to this issue, and highlights areas for future research. Every young patient with MI deserves a complete lipid assessment, a careful search for the underlying cause, questioning about substance use, and early cascade screening of first-degree relatives. Treating each young MI as a question to be answered, not only as an event to be managed, may help prevent further events in patients and their families.