title: [Acute myocardial infarction in patients under 45 years].
abstract: OBJECTIVE
  To evaluate the differential features of acute myocardial infarction in patients younger than 45 years old compared to older patients.
  
  
  METHODS
  From 1995 to 1999, delays in the assistance, evaluation, and therapeutic strategies as well as complications in patients hospitalized with a diagnosis of acute myocardial infarction, have been registered in the intensive care units of the 17 hospitals participating in the PRIMVAC Register.
  
  
  RESULTS
  During the study, 10,213 patients were registered, 6.8% younger than 45 years old (691 patients). Young patients show a greater prevalence of cigarette smoking (80.9 vs 34.1%; p < 0.0001) and hypercholesterolemia (39.9 vs 28.6%; p < 0.0001), whereas arterial hypertension, diabetes, and history of coronary disease were significantly more frequent in the older group. This subgroup reached the healthcare system at an earlier stage (120 vs 160 min; p < 0.0001). Thrombolysis was performed in 59.9% of patients younger than 45 years and in 45.9% of patients older than 45 years. Young patients were more frequently given aspirin (94.5%), heparin (70.6%), and beta-blocker drugs (38.4%), whereas patients older than 45 years were given a higher percentage of ACEI, digoxin, and inotropic drugs. Younger patients had a better prognosis and a lower mortality rate (3.5 vs 14%; p < 0.00001).
  
  
  CONCLUSIONS
  Acute myocardial infarction in patients younger than 45 years had different clinical features and responded to different therapeutic and diagnostic approaches than acute myocardial infarction in patients over 45 years, as well as a better short-term prognosis.
authors.affiliation: Sección de Cardiología. Hospital Universitario de San Juan. Alicante. España. pedromorillas@teleline.es
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Morillas
authors.forename: Adolfo
authors.initials: A
authors.lastname: Cabadés
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Echanove
authors.forename: Francisco
authors.initials: F
authors.lastname: Colomina
authors.forename: Javier
authors.initials: J
authors.lastname: Cebrián
authors.forename: Gloria
authors.initials: G
authors.lastname: Pérez
authors.forename: Angel
authors.initials: A
authors.lastname: Mota
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Sánchez
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Sanz
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012307:Risk Factors