Acute myocardial infarction in young patients

Kardiol Pol. 2021;79(10):1093-1098. doi: 10.33963/KP.a2021.0099. Epub 2021 Sep 2.

Abstract

Background: Acute myocardial infarction (AMI) is an incredibly destructive disease when it occurs in a young patient. Thus, the investigation of the disease presentation and treatment options seem to be particularly important in young patients with AMI.

Aims: The study objective was to investigate the differences between young and older patients diag-nosed with AMI in terms of clinical characteristics and treatment strategies.

Methods: The patient data comes from the National Registry of Procedures of Invasive Cardiology (ORPKI). Between 2014 and 2017, data of more than 230 000 patients with a diagnosis of AMI were collected in that registry. Young patients were defined as under 40 years old.

Results: Young patients with AMI (n = 3208, 1.3%) compared with older patients with AMI were more often men (86.3% vs. 65.8%; P <0.001) with higher body weight (mean 85.9 vs. 79.7 kg; P <0.001). Typical risk factors of coronary heart disease were less frequent in younger patients than in older patients. However, in the under-40 group, there was a significantly higher number of current smokers (37.5% vs. 23.0%; P <0.001). Young patients with AMI were more often diagnosed with ST-segment elevation myocardial infarction (STEMI; 62.0% vs. 50.0%; P <0.001). Moreover, they had more frequently non-significant ste-nosis in coronary arteries diagnosed (14.4% vs. 6.8%; P <0.001). The left anterior descending artery was more frequently an infarct-related artery in young patients (51.3% vs. 36.3%; P <0.001). Bioresorbable vascular scaffolds were more commonly implanted in young patients with AMI than in the older ones (5.6% vs. 0.9%; P <0.001). The relative number of AMI in the young patients increased from 1.20% in 2014 to 1.43% in 2017.

Conclusions: Smoking is the most common risk factor in young adults. The relative number of AMI in young patients is growing.

Keywords: acute myocardial infarction; angiography; coronary artery disease; percutaneous coronary intervention.

MeSH terms

  • Adult
  • Aged
  • Coronary Vessels
  • Humans
  • Male
  • Myocardial Infarction* / epidemiology
  • Percutaneous Coronary Intervention*
  • Registries
  • Risk Factors
  • ST Elevation Myocardial Infarction* / epidemiology
  • Young Adult