Clinical profile and prognosis of young patients with ST-elevation myocardial infarction managed by the emergency-intervention Codi IAM network
Rev Esp Cardiol (Engl Ed). 2023 Nov;76(11):881-890.
doi: 10.1016/j.rec.2023.03.008.
Epub 2023 Mar 22.
[Article in
English,
Spanish]
Authors
Eduardo Flores-Umanzor
1
, Pedro Cepas-Guillén
2
, Xavier Freixa
3
, Ander Regueiro
3
, Helena Tizón-Marcos
4
, Salvatore Brugaletta
3
, Albert Ariza-Solé
5
, Margarita Calvo
3
, Ilana Forado
3
, Xavier Carrillo
6
, Mérida Cárdenas
7
, Sergio Giovanny Rojas
8
, Juan Francisco Muñoz
9
, Joan García-Picart
10
, Rosa María Lidón
11
, Manel Sabaté
3
, Mónica Masotti
3
, Mercè Roqué
12
Affiliations
- 1 Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. Electronic address: https://twitter.com/@ejfu0209.
- 2 Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. Electronic address: https://twitter.com/@pedro_cepas.
- 3 Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain.
- 4 Servicio de Cardiología, Consorci Mar Parc de Salut de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
- 5 Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
- 6 Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
- 7 Servicio de Cardiología, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain.
- 8 Servicio de Cardiología, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain.
- 9 Servicio de Cardiología, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain.
- 10 Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- 11 Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
- 12 Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. Electronic address: mroque@clinic.cat.
Abstract
Introduction and objectives:
Data on the clinical profile and outcomes of younger patients with ST-elevation myocardial infarction (STEMI) is scarce. This study compared clinical characteristics and outcomes between patients aged<45 years and those aged ≥ 45 years with STEMI managed by the acute myocardial infarction code (AMI Code) network. Sex-based differences in the younger cohort were also analyzed.
Methods:
This multicenter study collected individual data from the Catalonian AMI Code network. Between 2015 and 2020, we enrolled patients with an admission diagnosis of STEMI. Primary endpoints were all-cause mortality within 30 days, 1 year, and 2 years.
Results:
Overall, 18 933 patients (23% female) were enrolled. Of them, 1403 participants (7.4%) were aged<45 years. Younger patients with STEMI were more frequently smokers (P<.001) and presented with cardiac arrest and TIMI flow 0 before pPCI (P<.05), but the time from first medical contact to wire crossing was shorter than in the older group (P<.05). All-cause mortality rates were lower in patients aged<45 years (P<.001). Among younger patients, cardiogenic shock was most prevalent in women than in their male counterparts (P=.002), with the time from symptom onset to reperfusion being longer (P<.05). Compared with men aged<45 years, younger women were less likely to undergo pPCI (P=.004).
Conclusions:
Despite showing high-risk features on admission, young patients exhibit better outcomes than older patients. Differences in ischemia times and treatment were observed between men and women.
Keywords:
Acute myocardial infarction; Coronary artery disease; Diferencias por sexo; Enfermedad coronaria; IAMCEST; Infarto agudo de miocardio; Pacientes jóvenes; STEMI; Sex gap; Younger patients.
Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Adult
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Female
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Humans
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Male
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Middle Aged
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Myocardial Infarction* / diagnosis
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Myocardial Infarction* / epidemiology
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Myocardial Infarction* / therapy
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Patient Admission
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Percutaneous Coronary Intervention*
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Prognosis
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Risk Factors
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ST Elevation Myocardial Infarction* / diagnosis
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ST Elevation Myocardial Infarction* / surgery