Acute myocardial infarction in the young--The University of Michigan experience.
BACKGROUND
The purpose of this study was to assess frequency, risk factors, treatment, and complications of very young patients with acute myocardial infarction (MI) at the University of Michigan Medical Center (UMMC).


METHODS
From a database of 976 consecutive patients admitted to the UMMC with acute MI between 1995 and 1998, we compared care and outcomes of patients divided into 3 age categories: <46 years, 46-54 years, and >54 years. Risk factors, presenting symptoms, type of MI, management, complications, and hospital outcomes of the 3 groups were evaluated.


RESULTS
Young patients represented >10% of all patients with acute MI, and >25% of these individuals were women, a number considerably higher than seen in previous studies. This group of young patients was more likely to have Q-wave MI and risk factors such as family history and tobacco use and less likely to have a history of angina. Although all 3 groups received similar inpatient treatment, there was more attention paid to risk factor modification such as smoking cessation and referral to cardiac rehabilitation in younger individuals. Young patients had fewer in-hospital complications and a lower mortality rate.


CONCLUSIONS
At the University of Michigan, >1 in 10 with acute MI is <46 years old. Data suggest that current management and aggressive risk factor modification are quite good in this particular group, and overall the mortality rate is very low.
Doughty
Michele
M
University of Michigan Heart Care Program and the Consortium for Health Care Outcomes, Innovation, and Cost Effectiveness Studies, Ann Arbor, Mich, USA. micheledoughty@hotmail.com
Mehta
Raj
R
Bruckman
David
D
Das
Sugata
S
Karavite
Dean
D
Tsai
Thomas
T
Eagle
Kim
K
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D006493:Heparin; D001241:Aspirin