Clinical and angiographic features of young patients with myocardial infarction
DOI:
https://doi.org/10.18203/2320-6012.ijrms20260589Keywords:
Myocardial infarction, Young patients, Troponin, Coronary angiography, Percutaneous coronary interventionAbstract
Background: Myocardial infarction (MI) is less common in young adults than in middle-aged and elderly people, but clinical interest to this problem is increasing due to the potential for premature death and long-term disability. Aim of the current study was to identify clinical, laboratory, and angiographic features of young (≤45 years) patients with MI.
Methods: The study included 81 patients with acute MI who were divided into 2 age categories: 34 patients ≤45 years old (group 1), and 47 patients >45 years old (group 2). All patients underwent laboratory and instrumental studies, including coronary angiography. Statistical analysis was performed using STATISTICA 12.0.
Results: The gender composition was represented predominantly by men (88% versus 81%, p>0.05). Young patients more often had ST-segment elevation on ECG (88%), while in older patients N-STEMI was more common (26% versus 12%, p=0.035). Younger patients had significantly higher troponin levels (p=0.028), indicating potentially greater myocardial injury. Angiographically, the incidence of single vessel disease was higher in patients below 45 years old (67.6 versus 29.7%, p<0.001).
Conclusions: The study identified that risk factors for early development of MI include primarily male gender, smoking, obesity, and hypertension. Single-vessel lesions with the involvement of the left anterior descending artery were the most common angiographic finding. The ability to predict the risk of developing cardiovascular disease in young people opens new prospects for developing a strategic approach to the care of young people at elevated risk.
Metrics
References
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-64. DOI: https://doi.org/10.1016/j.jacc.2018.08.1038
Camacho X, Nedkoff L, Wright FL, Nghiem N, Buajitti E, Goldacre R, et al. Relative contribution of trends in myocardial infarction event rates and case fatality to declines in mortality: an international comparative study of 1.95 million events in 80.4 million people in four countries. Lancet Public Health. 2022;7(3):e229-39. DOI: https://doi.org/10.1016/S2468-2667(22)00006-8
Ghafoor M, Kamal M, Nadeem U, Husain AN. Educational case: myocardial infarction: histopathology and timing of changes. Acad Pathol. 2020;7:2374289520976639. DOI: https://doi.org/10.1177/2374289520976639
Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168(2):934-45. DOI: https://doi.org/10.1016/j.ijcard.2012.10.046
Petrova MM, Anokhina AR, Ustyugov SA, Кaskaeva DS, Evsyukov AA, Shnaider NA. Epidemiology of acute myocardial infarction in the Russian Federation and abroad in the period from 2017 to 2024. CardioSomatics. 2025. DOI: https://doi.org/10.17816/CS646514
Mensah GA, Fuster V, Murray CJ, Roth GA, Abate YH, Abbasian M, et al. Global burden of cardiovascular diseases and risks, 1990-2022. J Am Coll Cardiol. 2023;82(25):2350-473. DOI: https://doi.org/10.1016/j.jacc.2023.11.007
Ando H, Yamaji K, Kohsaka S, Ishii H, Sakakura K, Goto R, et al. Clinical presentation and in-hospital outcomes of acute myocardial infarction in young patients: Japanese nationwide registry. JACC: Asia. 2022;2(5):574-85. DOI: https://doi.org/10.1016/j.jacasi.2022.03.013
Lei L, Bin Z. Risk factor differences in acute myocardial infarction between young and older people: a systematic review and meta-analysis. Int J Cardiovasc Sci. 2019;32(2):163-76. DOI: https://doi.org/10.5935/2359-4802.20190004
Rallidis LS, Xenogiannis I, Brilakis ES, Bhatt DL. Causes, angiographic characteristics, and management of premature myocardial infarction: JACC state-of-the-art review. J Am Coll Cardiol. 2022;79(24):2431-49. DOI: https://doi.org/10.1016/j.jacc.2022.04.015
Wittlinger T, Seifert C, Simonis G, Gerlach M, Strasser RH. Prognosis in myocardial infarction of young patients: results of a prospective registry. Int J Cardiol. 2020;300:1-6. DOI: https://doi.org/10.1016/j.ijcard.2019.10.037
Mehta RH, Rathore SS, Radford MJ, Wang Y, Wang Y, Krumholz HM. Acute myocardial infarction in the elderly: differences by age. J Am Coll Cardiol. 2001;38(3):736-41. DOI: https://doi.org/10.1016/S0735-1097(01)01432-2
Zimmerman FH, Cameron A, Fisher LD, Grace NG. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). J Am Coll Cardiol. 1995;26(3):654-61. DOI: https://doi.org/10.1016/0735-1097(95)00254-2
Walker NJ, Sites FD, Shofer FS, Hollander JE. Characteristics and outcomes of young adults who present to the emergency department with chest pain. Acad Emerg Med. 2001;8(7):703-8. DOI: https://doi.org/10.1111/j.1553-2712.2001.tb00188.x
Ricci B, Cenko E, Vasiljevic Z, Stankovic G, Kedev S, Kalpak O, et al. Acute Coronary Syndrome: The Risk to Young Women. J Am Heart Assoc. 2017;6(12):e007519. DOI: https://doi.org/10.1161/JAHA.117.007519
Choudhury T, West NE, El-Omar M. ST elevation myocardial infarction. Clin Med. 2016;16(3):277-82. DOI: https://doi.org/10.7861/clinmedicine.16-3-277
Mahjoob MP, Sadeghi S, Khanaman HF, Naderian M, Khaheshi I. Comparison of coronary risk factors and angiographic findings in younger and older patients with significant coronary artery disease. Rom J Intern Med. 2018;56(2):90-95. DOI: https://doi.org/10.1515/rjim-2017-0048
Deora S, Kumar T, Ramalingam R, Nanjappa Manjunath C. Demographic and angiographic profile in premature cases of acute coronary syndrome: analysis of 820 young patients from South India. Cardiovasc Diagn Ther. 2016;6(3):193-8. DOI: https://doi.org/10.21037/cdt.2016.03.05