Demographics and Angiographic Findings in Patients under 35 Years of Age with Acute ST Elevation Myocardial Infarction

Abstract

Background: ST-elevation myocardial infarction (STEMI) is a major cause of cardiovascular mortality worldwide. There are differences between very young patients with STEMI and their older counterparts.  This study investigates the demographics and clinical findings in very young patients with STEMI.
Methods: Through a review of the angiography registry, 108 patients aged ≤ 35 years (Group I) were compared with 5544 patients aged > 35 years (Group II) who underwent coronary angiography after STEMI.
Results: Group I patients were more likely to be male (92.6%), smokers, and have a family history of cardiovascular diseases (34.6%). The prevalence of diabetes, dyslipidemia, and hypertension was higher in the old patients. Triglyceride and hemoglobin were significantly higher in Group I. Normal coronary angiogram was reported in 18.5% of the young patients, and in 2.1% of the older patients. The prevalence of single-vessel and multi-vessel coronary artery disease was similar in the two groups (34.3% vs. 35.2%). The younger subjects were more commonly candidates for medical treatment and percutaneous coronary intervention (PCI) (84.2%), while coronary artery bypass grafting (CABG) was considered for the 39.5% of their older counterparts.   
Conclusion: In the young adults with STEMI, male gender, smoking, family history, and high triglyceride level were more often observed. A considerable proportion of the young patients presented with multi-vessel coronary disease. PCI or medical treatment was the preferred treatment in the younger patients; in contrast to their older counterparts, in whom CABG was more commonly chosen for revascularization.