Acute ST-elevation myocardial infarction in young patients: 15 years of experience in a single center.
BACKGROUND
There have been few studies done regarding young patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate the clinical characteristics and coronary angiographic features in young patients with STEMI.


METHODS
We collected data on 849 consecutive patients with STEMI from 1992 to 2006. Baseline clinical characteristics, coronary anatomy, and outcome were compared in young (< or =45 yrs) and older patients (>45 yrs).


RESULTS
Young patients presented 11.6% of all patients with STEMI. These patients were predominantly male (92.9% vs 80.3%, P < 0.001), more likely to smoke (75.8% vs 47.2%, P < 0.001), obese (48.2% vs 27.9%, P = 0.002), have higher triglyceride levels (176.9 +/- 153.8 mg/dL vs 140.7 +/- 112.7 mg/dL, P = 0.005), and lower high-density lipoprotein cholesterol (37.1 +/- 7.9 mg/dL vs 42.8 +/- 14.3 mg/dL, P = 0.005) than older patients. Also, younger patients had a shorter hospital stay (7.1 +/- 4.9 d vs 8.5 +/- 6.7 d, P = 0.04), less in-hospital morbidity (29.3% vs 39.7%, P = 0.02), and mortality (3.0% vs 12.3%, P = 0.002). Killip class III or IV could predict in-hospital morbidity and mortality in young patients. Both groups had similar rates of repeated percutaneous coronary intervention (PCI; 45.5% vs 41.5%, P = 0.23) and reinfarction (6.1% vs 3.2%, P = 0.32). Mortality rate during follow-up was significantly lower in younger patients (3.0% vs 19.6%, P < 0.001).


CONCLUSIONS
Cigarette smoking, obesity, and dyslipidemia were the most important modifiable risk factors in young patients with STEMI. These patients had a better outcome than older patients without differences in repeated PCI and reinfarction between them. Only Killip class III or IV could predict in-hospital morbidity and mortality in young patients with STEMI.
Chua
Su-Kiat
SK
Division of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Taipei, Taiwan.
Hung
Huei-Fong
HF
Shyu
Kou-Gi
KG
Cheng
Jun-Jack
JJ
Chiu
Chiung-Zuan
CZ
Chang
Che-Ming
CM
Lin
Sheng-Chang
SC
Liou
Jer-Young
JY
Lo
Huey-Ming
HM
Kuan
Peiliang
P
Lee
Shih-Huang
SH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D016001:Confidence Intervals; D017023:Coronary Angiography; D003331:Coronary Vessels; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013223:Statistics as Topic; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome